Topic:Asthma
Equine asthma, also known as equine recurrent airway obstruction (RAO) or heaves, is a chronic respiratory condition affecting horses. It is characterized by airway inflammation, mucus production, and bronchoconstriction, leading to clinical signs such as coughing, nasal discharge, and labored breathing. The condition is often exacerbated by environmental factors such as dust, mold, and pollen, which can trigger an immune response in susceptible horses. Equine asthma is managed through environmental modifications, medical treatments, and sometimes dietary adjustments to alleviate symptoms and improve respiratory function. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management strategies of equine asthma.
A wearable real-time particulate monitor demonstrates that soaking hay reduces dust exposure. Affordable particulate matter (PM) monitors suitable for use on horses will facilitate the evaluation of PM mitigation methods and improve the management of equine asthma. Objective: Calibrate a real-time wearable PM monitor (Black Beauty [BB]) and compare the PM exposures of horses fed dry or soaked hay. Methods: Laboratory calibration; complete cross-over feed trial. Methods: Side-by-side sampling with BB monitors and tapered element oscillating microbalances (TEOMs) was performed under varying concentrations of PM from alfalfa hay. Linear regression was used to derive a calibration formula ...
Exposure to respirable silica contributes to lower airway inflammation in asthmatic horses. Respirable mineral particles can induce lower airway inflammation, but the role they play in asthma of horses is unknown. Objective: Respirable mineral particles, particularly respirable silica, are an overlooked determinant of chronic lung inflammation (asthma) in horses. Methods: Twenty-three horses from an equine hospital population: 11 moderately affected (MEA), 7 severely asthmatic (SEA), and 5 control horses free from respiratory clinical signs. Methods: Prospective observational study. The quantity and quality of mineral particles found in bronchoalveolar lavage fluid (BALF) were charac...
Clinical variability of equine asthma phenotypes and analysis of diagnostic steps in phenotype differentiation. Equine asthma is a common, non-infectious, chronic lung disease that affects up to 80% of the horse population. Strict phenotyping and identification of subclinically asthmatic horses can be challenging. The aim of this study was to describe equine asthma phenotypes (mild, moderate, and severe asthma) defined by BALF cytology and occurrence of clinical signs in a population of privately owned horses and to identify the variables and examination steps with best discriminative potential. The standardised examination protocol included clinical examinations, blood work, airway endoscopy with bronc...
Association between equine asthma and fungal elements in the tracheal wash: An environment-matched case-control study. The presence of fungi in tracheal wash (TW) of horses was recently linked to mild-moderate equine asthma, indicating a possible causal role; however, increased numbers of fungi may also stem from asthma-related alteration of tracheal mucus clearance or from environmental exposure. Our objective was to elucidate the association between the presence of fungi in TW and asthma status while controlling for relevant confounders. We conducted a retrospective case-control study involving 73 horses, including 34 controls and 39 asthmatic cases. Each asthmatic horse was matched with a control from the s...
Steamed hay and alfalfa pellets for the management of severe equine asthma. Steaming hay significantly reduces respirable particles and provides a palatable alternative to dry hay for horses with asthma, but there are few prospective studies demonstrating the clinical efficacy of steamed hay. Objective: To compare the efficacy of alfalfa pellets and steamed hay in improving lung function and inflammation of horses with severe asthma (SEA). Methods: Controlled crossover study. Methods: Ten horses with SEA were enrolled and nine completed the study. Horses were housed indoors and fed hay. Once in exacerbation, they were fed pellets and steamed hay for 4 weeks, in a cr...
Aspergillus fumigatus antigen-reactive Th17 cells are enriched in bronchoalveolar lavage fluid in severe equine asthma. Equine asthma (EA) is a common disease of adult horses with chronic respiratory pathology and common neutrophilic airway inflammation. It presents with hyperreactivity to hay dust components such as molds, and underlying dysregulated T cell responses have been suggested. Thus far, T cells have been analysed in EA with conflicting results and the antigen reactivity of T cells has not been demonstrated. Serological and epidemiological data point to the relevance of as an antigen source in EA. Here, we aimed to identify and characterise antigen-reactive T cells in EA. Unassigned: Cryopreserved ...
Differences in pulmonary function measured by oscillometry between horses with mild-moderate equine asthma and healthy controls. The diagnosis of mild-moderate equine asthma (MEA) can be confirmed by airway endoscopy, bronchoalveolar lavage fluid (BALf) cytology, and lung function evaluation by indirect pleural pressure measurement. Oscillometry is a promising pulmonary function test method, but its ability to detect subclinical airway obstruction has been questioned. Objective: To evaluate the differences in lung function measured by oscillometry between healthy and MEA-affected horses. Methods: Prospective case-control clinical study. Methods: Thirty-seven horses were divided into healthy and MEA groups, based on hist...
Flow interruption compared to forced oscillatory maneuvers and esophageal balloon/pneumotachography for measurement of respiratory resistance in the horse. Pulmonary function testing is critical to the diagnosis of equine asthma (EA), an important cause of respiratory disease in the horse, but its clinical use has remained elusive, unfortunately, due to the complexity of reference methods, esophageal balloon/pneumotachography (EBP), and forced oscillatory mechanics (FOM), so we sought a noninvasive, portable method for use in horses through rapid interruption of airflow for equilibration of alveolar pressure with proximal airway pressure, termed flow interruption (FI). Resistance (RINT) was computed as the relationship between the change in press...
The amount of hyaluronic acid and airway remodelling increase with the severity of inflammation in neutrophilic equine asthma. Equine asthma (EA) is a chronic lower airway inflammation that leads to structural and functional changes. Hyaluronic acid (HA) has crucial functions in the extracellular matrix homeostasis and inflammatory mediator activity. HA concentration in the lungs increases in several human airway diseases. However, its associations with naturally occurring EA and airway remodelling have not been previously studied. Our aim was to investigate the association of equine neutrophilic airway inflammation (NAI) severity, airway remodelling, and HA concentration in horses with naturally occurring EA. We hypo...
Lipids in Equine Airway Inflammation: An Overview of Current Knowledge. Mild-moderate and severe equine asthma (MEA and SEA) are prevalent inflammatory airway conditions affecting horses of numerous breeds and disciplines. Despite extensive research, detailed disease pathophysiology and the differences between MEA and SEA are still not completely understood. Bronchoalveolar lavage fluid cytology, broadly used in clinical practice and in equine asthma research, has limited means to represent the inflammatory status in the lower airways. Lipidomics is a field of science that can be utilized in investigating cellular mechanisms and cell-to-cell interactions. Studies ...
Aspergillus fumigatus binding IgA and IgG1 are increased in bronchoalveolar lavage fluid of horses with neutrophilic asthma. Equine asthma (EA) is a common lower airway disease in horses, but whether its pathogenesis is allergic is ambiguous. Extrinsic stimuli like hay dust induce acute exacerbation of clinical signs and sustained local neutrophilic inflammation in susceptible horses. is an EA stimulus, but it is unclear if it merely acts as an IgE-provoking allergen. We aimed to comprehensively analyze immunoglobulin (Ig) isotypes in EA, elucidating their binding to different antigens, and their quantities systemically in serum and locally in bronchoalveolar lavage fluid (BALF). Unassigned: Serum and BALF from he...
Bilateral bronchoalveolar lavage cytology profiles in a warmblood horse population during a 1-year period. Bronchoalveolar lavage (BAL) cytology results from 1 lung might not be representative of both lungs. Objective: To determine whether the lung site sampled would influence the horse's BAL cytology profile, and if a pooled BAL sample would be superior with regard to BAL cytology diagnosis in a cohort of healthy and subclinical asthmatic warmblood horses. Methods: Fifty-nine horses in 2021 and 70 horses in 2022, the follow-up included 53 of the same in each year. Methods: A cross-sectional study with follow-up included BAL cytology samples from individual lungs and from pooled BAL samples. The BA...
Towards personalized medicine for the treatment of equine asthma. Although horses with asthma share similar clinical signs, the heterogeneity of the disease in terms of severity, triggering factors, inflammatory profile, and pathological features has hindered our ability to define biologically distinct subgroups. The recognition of phenotypes and endotypes could enable the development of precision medicine, including personalized, targeted therapy, to benefit affected horses. While in its infancy in horses, this review outlines the phenotypes of equine asthma and discusses how knowledge gained from targeted therapy in human medicine can be applied to evaluat...
Clinical findings and outcome predictors for multinodular pulmonary fibrosis in horses: 46 cases (2009-2019). Prognostic indicators for equine multinodular pulmonary fibrosis (EMPF), an interstitial fibrosing lung disease, are poorly described. Objective: Describe diagnostic findings and outcome predictors for EMPF. Methods: Forty-six adult horses with EMPF. Methods: Retrospective multicenter case series from 2009 to 2019. Radiographic (n = 27) and ultrasonographic studies (n = 19) from EMPF horses and bronchoalveolar lavage fluid (BALF) cytology from 6 EMPF and 13 asthma cases were independently reviewed and blinded to diagnosis and outcome. Associations between predictor variables and surviv...
Comparative study of the bronchodilator efficacy and adverse effects of salbutamol and hyoscine butylbromide in horses with severe asthma. Salbutamol and hyoscine butylbromide (HBB) are commonly used bronchodilators in horses with severe asthma (SA). Objective: To compare the bronchodilation potency, duration, and adverse effects of salbutamol and HBB in SA. Methods: Six horses in exacerbation of SA. Methods: The effects of inhaled salbutamol (1000 μg) and HBB (150 mg, IV) were compared in a randomized, blinded, crossover experiment. Lung function, intestinal borborygmi and heart rate were assessed before and sequentially until 180 minutes after drug administration, and analyzed with 2-way repeated-measures ANOVA and Dunne...
Effects of tamoxifen on the immune response phenotype in equine peripheral blood mononuclear cells. Tamoxifen (TAM) is widely utilized in the prevention and treatment of human breast cancer and has demonstrated the potential to modulate the immune response. It has been proposed as a therapeutic tool for immune-mediated diseases. TAM has been investigated as a possible treatment for asthma-like conditions in horses, revealing specific impacts on the innate immune system. While the effects of TAM on equine neutrophils are well-documented, its influence on lymphocytes and the modulation of the immune response polarization remains unclear. This study employed peripheral blood mononuclear cells ...
A cross-sectional observational study of birefringent particulates in bronchoalveolar lavage cytology in horses with equine asthma from the West v East coasts of the USA. Equine asthma (EA) is an important cause of wastage in the USA horse industry. Exposure to organic particulates, from stable dust, airborne pollen, and fungal loads, is posited to be the main cause. Dust arising from the earth's crust has been largely ignored as a contributor to EA in the veterinary literature. The objectives of this study were to investigate the occurrence of birefringent particulates in the bronchoalveolar lavage fluid (BALF) of horses with a clinical complaint of EA residing in the arid West of the USA v. the East, in an effort to determine the contribution of geolocation t...
Equine Asthma Does Not Affect Circulating Myostatin Concentrations in Horses. (1) Background: The number of horses suffering from chronic respiratory diseases, resembling human asthma, is increasing but there is still a lack of reliable and accurate methods to detect these disorders. Numerous studies have found elevated plasma concentrations of one of the myokines, namely, myostatin (MSTN), in people suffering from severe asthma. MSTN normally inhibits myoblast proliferation and differentiation through autocrine or paracrine signals. Therefore, given the pathogenesis of asthma, we hypothesize that MSTN could be a useful biomarker of equine asthma. Thus, this study aimed...
Immunoproteomics enable broad identification of new Aspergillus fumigatus antigens in severe equine asthma. Severe equine asthma (SEA) is a common chronic disease of adult horses with characteristic recurrent airway obstruction and similarities to neutrophilic asthma in humans. As an extrinsic stimulus, hay dust exposure is a major risk factor and induces acute exacerbation in susceptible horses. However, single inducing agents of SEA have hardly been identified on a molecular basis. () is a common mold species in hay and has been described as a major provoking agent of SEA. Unassigned: Aiming to identify disease-relevant antigens, we analyzed using an immunoproteomics approach on two-dimensional ...
Exposure to chemical pollutants and biological aerosol in indoor facilities for recreational and sport horses. Due to the increasing prevalence of equine non-infectious respiratory disease, the air contamination in equine housing (Stables A-C) and training facilities (indoor riding arenas A - C) was investigated. The aim of the study was to monitor gaseous pollutants, bioaerosols, and dust concentrations at three different sites (stables and riding halls), where different floor materials were used in the riding halls. Methods: Air quality was monitored in housing for horses and in riding halls in terms of dust concentration, the presence of gaseous chemical pollutants, and concentrations of biological ...
Current Understanding of Equine Gut Dysbiosis and Microbiota Manipulation Techniques: Comparison with Current Knowledge in Other Species. Understanding the importance of intestinal microbiota in horses and the factors influencing its composition have been the focus of many studies over the past few years. Factors such as age, diet, antibiotic administration, and geographic location can affect the gut microbiota. The intra- and inter-individual variability of fecal microbiota in horses complicates its interpretation and has hindered the establishment of a clear definition for dysbiosis. Although a definitive causal relationship between gut dysbiosis in horses and diseases has not been clearly identified, recent research suggests ...
Cytokine mRNA expression in the bronchoalveolar lavage cells from horses affected by different equine asthma subtypes. Equine asthma (EA) is a respiratory syndrome associated with the increase of different leukocyte populations in the bronchoalveolar lavage fluid (BALF). Its pathogenetic mechanisms remain unclear. This study aimed to evaluate the associations between the mRNA expression of different cytokines in the BALF, different EA subtypes and lung function. Fifteen horses underwent physical examination, airway endoscopy, BALF cytology and lung function testing (8/15). One horse did not have evidence of EA and was used as healthy reference, while the others were classified as affected by neutrophilic or mi...
Low levels of microRNA-21 in neutrophil-derived exosomes may contribute to airway smooth muscle hyperproliferation in horses with severe asthma. Neutrophilic inflammation is associated with the degree of airway obstruction in severe equine asthma (SEA), but the contribution of these leukocytes to bronchial remodeling remains ill defined. Neutrophils could cause structural alterations of the airways by the release of exosomes, a type of cell-derived nanoparticles that can modify the biology of local and distant cells. Neutrophil-derived exosomes have been shown to increase airway smooth muscle (ASM) cell proliferation in humans and horses. Therefore, this study aimed to identify neutrophil exosomal microRNAs (miRs) implicated in the reg...
Environmental Management of Equine Asthma. Environmental practices related to the inhalation of airborne dust have been identified as the main cause of equine asthma (EA) and reasonably, they are truly relevant in its treatment and control, especially for horses with its severe form. Vast research regarding environmental recommendations has been conducted in recent years. However, no recent exhaustive reviews exist that gather all this new evidence. The aim of this review is to report and compare the most pertinent information concerning the environmental management of EA. The main findings highlight the importance of the type of forag...
Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey. Equine asthma is considered a non-infectious respiratory disease characterized by inflammation and hypersensitivity. Given the importance of antimicrobial stewardship, an international survey was designed to investigate the use of antimicrobials in asthmatic horses and the factors influencing prescription behavior. An online survey was distributed in six languages by international mailing lists and social media from December 2020 to January 2022. Of the 434 responses recorded, 249 veterinarians working in 25 countries finished the survey. These included 79 ECEIM/ACVIM diplomats. A total of 204...
Respiratory oscillometry testing in relation to exercise in healthy and asthmatic Thoroughbreds. Racehorses may experience exercise-induced bronchodilation or bronchoconstriction, with potential differences between healthy and asthmatic individuals. Objective: To identify exercise-related lung function variations by oscillometry in racehorses, compare lung function between healthy and mild equine asthma (MEA) horses, assess oscillometry's potential as a predictor of racing fitness. Methods: Prospective case-control clinical study. Methods: Fourteen Thoroughbred racehorses (5 healthy, 9 MEA) underwent a protocol including respiratory oscillometry at rest, exercise with fitness monitoring, ...
The Microbiota and Equine Asthma: An Integrative View of the Gut-Lung Axis. Both microbe-microbe and host-microbe interactions can have effects beyond the local environment and influence immunological responses in remote organs such as the lungs. The crosstalk between the gut and the lungs, which is supported by complex connections and intricate pathways, is defined as the gut-lung axis. This review aimed to report on the potential role of the gut-lung gut-lung axis in the development and persistence of equine asthma. We summarized significant determinants in the development of asthma in horses and humans. The article discusses the gut-lung axis and proposes an integr...
Breath characteristics and adventitious lung sounds in healthy and asthmatic horses. Standard thoracic auscultation suffers from limitations, and no systematic analysis of breath sounds in asthmatic horses exists. Objective: First, characterize breath sounds in horses recorded using a novel digital auscultation device (DAD). Second, use DAD to compare breath variables and occurrence of adventitious sounds in healthy and asthmatic horses. Methods: Twelve healthy control horses (ctl), 12 horses with mild to moderate asthma (mEA), 10 horses with severe asthma (sEA) (5 in remission [sEA-], and 5 in exacerbation [sEA+]). Methods: Prospective multicenter case-control study. Horses w...
Single-cell profiling of bronchoalveolar cells reveals a Th17 signature in neutrophilic severe equine asthma. Severe equine asthma (SEA) is a complex respiratory condition characterized by chronic airway inflammation. It shares many clinical and pathological features with human neutrophilic asthma, making it a valuable model for studying this condition. However, the immune mechanisms driving SEA have remained elusive. Although SEA has been primarily associated with a Th2 response, there have also been reports of Th1, Th17, or mixed-mediated responses. To uncover the elusive immune mechanisms driving SEA, we performed single-cell mRNA sequencing (scRNA-seq) on cryopreserved bronchoalveolar cells from 1...
Decision Making in Severe Equine Asthma-Diagnosis and Monitoring. Decision making consists of gathering quality data in order to correctly assess a situation and determine the best course of action. This process is a fundamental part of medicine and is what enables practitioners to accurately diagnose diseases and select appropriate treatment protocols. Despite severe equine asthma (SEA) being a highly prevalent lower respiratory disease amongst equids, clinicians still struggle with the optimization of routine diagnostic procedures. The use of several ancillary diagnostic tests has been reported for disease identification and monitoring, but many are only s...