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Topic:Recurrent Airway Obstruction

Recurrent Airway Obstruction (RAO) is a chronic respiratory condition in horses characterized by airway inflammation, bronchoconstriction, and mucus accumulation. It is often triggered by exposure to environmental allergens such as dust, mold, and pollen. Horses with RAO exhibit symptoms including coughing, nasal discharge, and labored breathing, particularly during exercise or in dusty environments. The condition is comparable to asthma in humans and can significantly impact a horse's respiratory function and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, management, and treatment of Recurrent Airway Obstruction in equine populations.
Antioxidant supplementation in horses affected by recurrent airway obstruction.
The Journal of nutrition    July 31, 2004   Volume 134, Issue 8 Suppl 2065S-2067S doi: 10.1093/jn/134.8.2065S
Deaton CM, Marlin DJ, Smith NC, Harris PA, Schroter RC, Kelly FJ.No abstract available
Application of the comet assay for investigation of oxidative DNA damage in equine peripheral blood mononuclear cells.
The Journal of nutrition    July 31, 2004   Volume 134, Issue 8 Suppl 2133S-2140S doi: 10.1093/jn/134.8.2133S
Marlin DJ, Johnson L, Kingston DA, Smith NC, Deaton CM, Mann S, Heaton P, Van Vugt F, Saunders K, Kydd J, Harris PA.Oxidative stress occurs when antioxidant defense mechanisms are overwhelmed by free radicals and may lead to DNA damage, which has been implicated in processes such as aging and diseases such as cancer. The two main techniques presently used to quantify DNA damage are measurement of 8-hydroxydeoxyguanosine and the Comet assay (also known as single-cell gel electrophoresis). The aim of this study was to apply the comet assay to equine peripheral blood mononuclear cells (PBMCs) and identify two conditions in which we hypothesized that oxidative DNA damage would be increased in PBMCs: aging and e...
Efficacy of oral and intravenous dexamethasone in horses with recurrent airway obstruction.
Equine veterinary journal    July 16, 2004   Volume 36, Issue 5 426-430 doi: 10.2746/0425164044868413
Cornelisse CJ, Robinson NE, Berney CE, Kobe CA, Boruta DT, Derksen FJ.Although the efficacy of dexamethasone for the treatment of recurrent airway obstruction (RAO) has been documented, the speed of onset of effect and duration of action are unknown, as is the efficacy of orally administered dexamethasone with or without fasting. Objective: To document the time of onset of effect and duration of action of a dexamethasone solution i.v. or orally with and without fasting. Methods: Protocol 1 used 8 RAO-affected horses with airway obstruction in a crossover design experiment that compared the effect of i.v. saline and dexamethasone (0.1 mg/kg bwt) on pulmonary func...
Breath condensate hydrogen peroxide correlates with both airway cytology and epithelial lining fluid ascorbic acid concentration in the horse.
Free radical research    April 24, 2004   Volume 38, Issue 2 201-208 doi: 10.1080/10715160310001638047
Deaton CM, Marlin DJ, Smith NC, Smith KC, Newton RJ, Gower SM, Cade SM, Roberts CA, Harris PA, Schroter RC, Kelly FJ.The relationship between hydrogen peroxide (H2O2) concentration in expired breath condensate (EBC) and cytology of the respiratory tract obtained from tracheal wash (TW) or bronchoalveolar lavage (BAL), and epithelial lining fluid (ELF) antioxidant status is unknown. To examine this we analysed the concentration of H2O2 in breath condensate from healthy horses and horses affected by recurrent airway obstruction (RAO), a condition considered to be an animal model of human asthma. The degree of airway inflammation was determined by assessing TW inflammation as mucus, cell density and neutrophil ...
Assessment of leukotriene B4 production in leukocytes from horses with recurrent airway obstruction.
American journal of veterinary research    March 19, 2004   Volume 65, Issue 3 289-295 doi: 10.2460/ajvr.2004.65.289
Lindberg A, Robinson NE, Näsman-Glaser B, Jensen-Waern M, Lindgren JA.To determine the ex vivo leukotriene (LT) biosynthesis in peripheral blood neutrophils (PBNs) and inflammatory cells in bronchoalveolar lavage fluid (BALF) obtained from horses affected with recurrent airway obstruction (RAO). Methods: 6 RAO-affected and 6 control horses. Methods: Before and 6, 24, and 48 hours after stabling, disease severity was determined subjectively by clinical and mucus scores and measurement of the maximal change in pleural pressure (deltaPpl(max)); PBNs were isolated and BALF samples were examined cytologically. The PBN and BALF cells were activated with a calcium iono...
[Mite allergy in the domestic horse: experience of an equine veterinarian specializing in the field of allergy].
European annals of allergy and clinical immunology    March 16, 2004   Volume 36, Issue 1 6-8 
Volland-Francqueville M, Sabbah A.When medical history and clinical examination for a recurrent or chronic cough reveal the presence of perennial allergy, the practitioner would be advised to look for mites present in the horse's environment. He can propose this service to his clients.
Energetic cost of breathing, body composition, and pulmonary function in horses with recurrent airway obstruction.
Journal of applied physiology (Bethesda, Md. : 1985)    February 13, 2004   Volume 97, Issue 1 91-97 doi: 10.1152/japplphysiol.00629.2003
Mazan MR, Deveney EF, DeWitt S, Bedenice D, Hoffman A.This study was conducted to determine whether horses with naturally occurring, severe chronic recurrent airway obstruction (RAO) 1). have a greater resting energy expenditure (REE) than control horses, 2). suffer body mass depletion, and 3). have significantly decreased REE after bronchodilation and, therefore, also 4). whether increased work of breathing contributes to the cachexia seen in some horses with RAO. Six RAO horses and six control horses underwent indirect calorimetric measures of REE and pulmonary function testing using the esophageal balloon-pneumotachograph method before and aft...
Airway mucus in recurrent airway obstruction–short-term response to environmental challenge.
Journal of veterinary internal medicine    February 10, 2004   Volume 18, Issue 1 92-97 doi: 10.1892/0891-6640(2004)18<92:amirao>2.0.co;2
Gerber V, Lindberg A, Berney C, Robinson NE.Mucus accumulation and neutrophilic inflammation in the airways are hallmarks of heaves. Endoscopically visible mucus accumulations, however, have not been studied during exposure to dusty hay and allergens (ie, environmental challenge). We hypothesized that (1) heaves-affected horses have increased mucus accumulation compared with controls, (2) mucus accumulations increase in heaves-affected horses during environmental challenge, and (3) environmental challenge also induces neutrophilic inflammation and mucus accumulation in control horses. Mucus accumulation was graded endoscopically (mucus ...
Pulmonary epithelial lining fluid and plasma ascorbic acid concentrations in horses affected by recurrent airway obstruction.
American journal of veterinary research    January 15, 2004   Volume 65, Issue 1 80-87 doi: 10.2460/ajvr.2004.65.80
Deaton CM, Marlin DJ, Smith NC, Harris PA, Roberts CA, Schroter RC, Kelly FJ.To determine the pulmonary epithelial lining fluid (ELF) concentrations and degree of oxidation of ascorbic acid in horses affected by recurrent airway obstruction (RAO) in the presence and absence of neutrophilic airway inflammation. Methods: 6 RAO-affected horses and 8 healthy control horses. Methods: Nonenzymatic antioxidant concentrations were determined in RBC, plasma, and ELF samples of control horses and RAO-affected horses in the presence and absence of airway inflammation. Results: ELF ascorbic acid concentration was decreased in RAO-affected horses with airway inflammation (median, 0...
IL-4, IL-5 and IFN-gamma mRNA expression in pulmonary lymphocytes in equine heaves.
Veterinary immunology and immunopathology    January 1, 2004   Volume 97, Issue 1-2 87-96 doi: 10.1016/j.vetimm.2003.08.013
Cordeau ME, Joubert P, Dewachi O, Hamid Q, Lavoie JP.Heaves is a common condition of horses of cold climate that is characterized by small airway inflammation and obstruction following exposure of susceptible horses to moldy hay and straw. It has been shown that helper T lymphocytes (Th) orchestrate the inflammatory response in asthma and in various animal models of allergic lung diseases by the release of Th2-type cytokines. Results of previous studies indicate that a predominant expression of Th2-type response by airway cells may also be present in heaves. To evaluate the temporal mRNA expression of Th1 (IFN-gamma) and Th2 (IL-4, IL-5) type cy...
Analysis of risk factors for recurrent airway obstruction in North American horses: 1,444 cases (1990-1999).
Journal of the American Veterinary Medical Association    December 11, 2003   Volume 223, Issue 11 1645-1650 doi: 10.2460/javma.2003.223.1645
Couëtil LL, Ward MP.To identify risk factors for recurrent airway obstruction (RAO) among horses examined at veterinary teaching hospitals in North America. Methods: Retrospective case-control study. Methods: 1,444 horses with RAO and 1,444 control horses examined for other reasons. Methods: The Veterinary Medical Database was searched for records of horses in which RAO was diagnosed. A control group was identified by randomly selecting a horse with a diagnosis other than RAO that matched the institution and year of admission for each of the horses with RAO. Information obtained included hospital, admission year ...
Use of the impulse oscillometry system for testing pulmonary function during methacholine bronchoprovocation in horses.
American journal of veterinary research    November 19, 2003   Volume 64, Issue 11 1414-1420 doi: 10.2460/ajvr.2003.64.1414
van Erck E, Votion DM, Kirschvink N, Art T, Lekeux P.To compare sensitivity of the impulse oscillometry system (IOS) with that of the conventional reference technique (CRT; ie, esophageal balloon method) for pulmonary function testing in horses. Methods: 10 horses (4 healthy; 6 with recurrent airway obstruction [heaves] in remission). Methods: Healthy horses (group-A horses) and heaves-affected horses (group-B horses) were housed in a controlled environment. At each step of a methacholine bronchoprovocation test, threshold concentration (TC(2SD); results in a 2-fold increase in SD of a value) and sensitivity index (SI) were determined for respir...
Recurrent airway obstruction (RAO) in horses is characterized by IFN-gamma and IL-8 production in bronchoalveolar lavage cells.
Veterinary immunology and immunopathology    October 3, 2003   Volume 96, Issue 1-2 83-91 doi: 10.1016/s0165-2427(03)00142-9
Ainsworth DM, Grünig G, Matychak MB, Young J, Wagner B, Erb HN, Antczak DF.In horses prone to developing recurrent airway obstruction (RAO), we tested the hypotheses that the cytokine profile in the bronchoalveolar lavage (BAL) cells of affected horses would reflect a polarized Th-2 response; that cytokine and chemokine alterations would occur within 24 h of allergen exposure; and that allergen exposure would induce alterations in the expression of the transcription factor t-bet (t-box-expressed in T-cells). The expression levels of interleukin-4 (IL-4), IL-13, Interferon-gamma (IFN-gamma), t-bet, IL-8 and granulocyte-macrophage colony stimulating factor (GM-CSF) wer...
Comparison of the caudal lung borders determined by percussion and ultrasonography in horses with recurrent airway obstruction.
Acta veterinaria Hungarica    October 1, 2003   Volume 51, Issue 3 249-258 doi: 10.1556/AVet.51.2003.3.1
Bakos Z, Vörös K, Kellokoski H, Reiczigel J.The aim of the study was to evaluate the diagnostic value of thoracic percussion and ultrasonography with the help of distance measurements and statistical methods in the determination of the caudal lung border in horses with recurrent airway obstruction (RAO). Examinations were performed on 11 healthy, warm-blooded horses of different breeds, age and grade of disease. First, the caudal lung border was determined by the traditional indirect percussion method in the 10th, 12th, 14th and 16th intercostal spaces at the end of inspiration and expiration on both sides of the thorax. To apply standa...
Endotoxin contamination contributes to the pulmonary inflammatory and functional response to Aspergillus fumigatus extract inhalation in heaves horses.
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology    September 6, 2003   Volume 33, Issue 9 1289-1296 doi: 10.1046/j.1365-2745.2003.01651.x
Pirie RS, Dixon PM, McGorum BC.Mould extract inhalation challenges have been used extensively in the investigation of heaves. Such challenges have induced pulmonary neutrophilic inflammation and dysfunction, consistent with, but less severe than the natural disease. However, the method of mould extract production is likely to result in endotoxin contamination. Objective: To investigate whether insufficient dose delivery was responsible for the shortfall in response to inhaled extract compared with natural disease, and whether endotoxin contamination of mould extract contributed to the pulmonary inflammation and dysfunction....
Comparison of efficacy and tolerability of isoflupredone and dexamethasone in the treatment of horses affected with recurrent airway obstruction (‘heaves’).
Equine veterinary journal    July 26, 2003   Volume 35, Issue 4 419-424 doi: 10.2746/042516403776014208
Picandet V, Léguillette R, Lavoie JP.Corticosteroids are currently the most effective drugs for the control of 'heaves' in horses. However, there is limited information concerning the comparative efficacy and tolerability of the various corticosteroids when used for treatment. Objective: To compare the therapeutic and side effects of isoflupredone acetate to those of dexamethasone. Methods: A parallel design to compare the effects of 2 corticosteroids by evaluating lung function, serum cortisol and electrolyte concentrations, response to ACTH stimulation and haematology sequentially during a 14 day control period (no treatment), ...
Coughing, mucus accumulation, airway obstruction, and airway inflammation in control horses and horses affected with recurrent airway obstruction.
American journal of veterinary research    May 21, 2003   Volume 64, Issue 5 550-557 doi: 10.2460/ajvr.2003.64.550
Robinson NE, Berney C, Eberhart S, deFeijter-Rupp HL, Jefcoat AM, Cornelisse CJ, Gerber VM, Derksen FJ.To investigate relationships between cough frequency and mucus accumulation, airway obstruction, and airway inflammation and to determine effects of dexamethasone on coughing and mucus score. Methods: 13 horses with recurrent airway obstruction (RAO) and 6 control horses. Methods: 6 RAO-affected and 6 control horses were stabled for 3 days. Coughing was counted for 4 hours before and on each day horses were stabled. Before and on day 3 of stabling, tracheal mucus accumulation was scored, airway obstruction was assessed via maximal change in pleural pressure (deltaPpl(max)), and airway inflamma...
Mucin genes in horse airways: MUC5AC, but not MUC2, may play a role in recurrent airway obstruction.
Equine veterinary journal    May 21, 2003   Volume 35, Issue 3 252-257 doi: 10.2746/042516403776148291
Gerber V, Robinson NE, Venta RJ, Rawson J, Jefcoat AM, Hotchkiss JA.Increased mucin gene expression may be an important cause of mucus accumulation observed in recurrent airway obstruction (RAO)-affected horses. To date, however, no mucin gene sequences are available for the horse. Objective: To identify equine homologues of gel-forming mucins and investigate their expression at different airway generations of healthy and RAO-affected horses. Methods: Two equine homologues were identified by cloning and sequencing fragments of equine (eq)MUC5AC and eqMUC2. Results: Semiquantitative RT-PCR on RNA from airways (generations 1, 5, 10, 15; small airways and parench...
Study of the effect of Bronchipret on the lung function of five Austrian saddle horses suffering recurrent airway obstruction (heaves).
The Veterinary record    May 20, 2003   Volume 152, Issue 18 555-557 doi: 10.1136/vr.152.18.555
van den Hoven R, Zappe H, Zitterl-Eglseer K, Jugl M, Franz C.The effects of an oral preparation containing an extract of thyme and primula (Bronchipret; Bionorica) on the lung function of five horses suffering heaves were determined in a longitudinal study. The horses accepted the product well. The plasma concentrations of the marker substance, thymol, indicated that at least one of the substances in the extract had been absorbed from the gastrointestinal tract. The compliance, pulmonary pressure and airway resistance of the horses' lungs were all significantly improved after one month of treatment However, the severity of their clinical signs and their...
Inhaled endotoxin and organic dust particulates have synergistic proinflammatory effects in equine heaves (organic dust-induced asthma).
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology    May 20, 2003   Volume 33, Issue 5 676-683 doi: 10.1046/j.1365-2222.2003.01640.x
Pirie RS, Collie DD, Dixon PM, McGorum BC.Equine heaves is a naturally occurring organic dust-induced asthma characterized by airway neutrophilia, mucus hypersecretion and obstructive lung dysfunction. However, the relative role of different dust components in disease severity remains unclear. Objective: This study investigated the relative contribution of inhaled endotoxin and organic dust particulates (mainly mould spores) in inducing heaves in heaves-susceptible horses. Methods: Control and heaves-susceptible horses received inhalation challenges with hay dust suspension (HDS) before and after lipopolysaccharide (LPS) depletion. He...
Recurrent airway obstruction–heaves.
The Veterinary clinics of North America. Equine practice    May 16, 2003   Volume 19, Issue 1 63-vi doi: 10.1016/s0749-0739(02)00067-6
Léguillette R.Heaves, or recurrent airway obstruction (RAO), is a chronic respiratory disease featuring lower airway inflammation, bronchoconstriction, and mucus accumulation. Inhaled organic dusts and T helper 2 type immunologic reactions are involved in the complex pathophysiology of RAO. Clinical signs vary and alternate with remission periods. The diagnosis is often based on history and clinical examination in severe cases, but bronchoalveolar lavage may be useful for the detection of early cases. The most important aspect of treatment is to avoid exposure to allergens. Corticosteroids may be administer...
In vitro and ex vivo effects of the phosphodiesterase 4 inhibitor, rolipram, on thromboxane production in equine blood.
Journal of veterinary pharmacology and therapeutics    April 2, 2003   Volume 26, Issue 2 123-130 doi: 10.1046/j.1365-2885.2003.00450.x
Rickards KJ, Page CP, Lees P, Gettinby G, Cunningham FM.Phosphodiesterase 4 (PDE4) inhibitors have been shown to inhibit equine neutrophil function in vitro and may be of benefit in recurrent airway obstruction (RAO), an allergy-based respiratory disease characterized by inflammatory cell recruitment and activation within the lungs following exposure of susceptible horses to allergens in mouldy hay. The aim of this study was to evaluate the inhibitory effects of the PDE4 inhibitor, rolipram, in an in vitro assay of thromboxane (Tx) production. The assay was then used to monitor the activity of this compound in vivo in normal and RAO-affected horses...
Use of volumetric capnography to identify pulmonary dysfunction in horses with and without clinically apparent recurrent airway obstruction.
American journal of veterinary research    March 29, 2003   Volume 64, Issue 3 338-345 doi: 10.2460/ajvr.2003.64.338
Herholz CP, Gerber V, Tschudi P, Straub R, Imhof A, Busato A.To investigate whether volumetric capnography indices could be used to differentiate between horses without recurrent airway obstruction (RAO) and horses with RAO that were in clinical remission or that had clinically apparent RAO. Methods: 70 adult Swiss Warmblood horses (20 used for pleasure riding and 50 used for dressage or show jumping). Methods: Horses were allocated to 4 groups on the basis of history, clinical signs, results of endoscopy, and cytologic findings (group 1, 21 healthy horses; group 2, 22 horses with RAO that were in remission; group 3, 16 horses with mild RAO; group 4, 11...
A recombinant envelope protein-based enzyme-linked immunosorbent assay for West Nile virus serodiagnosis.
Vector borne and zoonotic diseases (Larchmont, N.Y.)    March 26, 2003   Volume 2, Issue 2 105-109 doi: 10.1089/153036602321131904
Wang T, Magnarelli LA, Anderson JF, Gould LH, Bushmich SL, Wong SJ, Fikrig E.Recombinant West Nile virus envelope (E) protein was examined in enzyme-linked immunosorbent assay (ELISA) to detect antibodies elicited during West Nile virus infection. Horses (nine of 10) and humans (six of six) with confirmed West Nile virus infection had IgG and/or IgM antibodies to the E protein. Antibodies to the recombinant West Nile virus membrane and nonstructural 1 proteins were not detected in any of these sera. An E protein-based ELISA may aid in the serological diagnosis of West Nile virus infection.
Measurement of tidal breathing flow-volume loop indices in horses used for different sporting purposes with and without recurrent airway obstruction.
The Veterinary record    March 26, 2003   Volume 152, Issue 10 288-292 doi: 10.1136/vr.152.10.288
Herholz C, Straub R, Braendlin C, Imhof A, Lüthi S, Busato A.Tidal breathing flow-volume loop (TBFVL) indices in healthy horses and in horses suffering from mild and moderate to severe recurrent airway obstruction (RAO) were measured. In addition, the ability of these indices to differentiate healthy controls from horses with mild RAO by separating the horses according to their usage was investigated. The horses were assigned to three sporting categories: 1 Leisure horses; 2 Horses competing at events with a duration of more than five minutes (eventing, coaching and endurance); and 3 Horses competing at events with a duration of less than five minutes (...
Effect of aerosolized albuterol sulfate on resting energy expenditure determined by use of open-flow indirect calorimetry in horses with recurrent airway obstruction.
American journal of veterinary research    February 27, 2003   Volume 64, Issue 2 235-242 doi: 10.2460/ajvr.2003.64.235
Mazan MR, Hoffman AM, Kuehn H, Deveney EF.To evaluate effects of sedation on stability of resistance of the respiratory system (RRS) and measures of resting energy expenditure (REE) by use of open-flow indirect calorimetry (IC) and treatment with aerosolized albuterol on REE in horses with recurrent airway obstruction (RAO). Methods: 9 clinically normal horses and 8 horses with RAO. Methods: In phase 1, RRS was measured by using forced oscillometry (FOT) in 5 clinically normal horses before and after sedation with xylazine. In phase 2, REE was measured in 4 clinically normal horses between 20 and 25 minutes and again 35 to 40 minutes ...
Four cases of equine polysaccharide storage myopathy in the United Kingdom.
The Veterinary record    February 8, 2003   Volume 152, Issue 4 109-112 doi: 10.1136/vr.152.4.109
McGowan CM, Menzies-Gow NJ, McDiarmid AM, Patterson-Kane JC.This paper describes four cases of equine polysaccharide storage myopathy which were confirmed by histological examination of muscle biopsy specimens. The horses were of mixed breeding, with warmblood and thoroughbred dominating. They all had recurrent episodes of rhabdomyolysis, indicated by clinical signs and increased plasma levels of muscle enzymes. They were managed conservatively and have continued athletic careers despite their disease.
The role of apoptotic regulators in metaplastic mucous cells.
Novartis Foundation symposium    February 6, 2003   Volume 248 221-282 
Tesfaigzi Y.Exposure of airways to environmental toxins or allergens induces proliferation of epithelial cells. Depending on the type of exposure, existing and newly formed cells can differentiate into mucus-producing cells resulting in mucous cell metaplasia (MCM). During recovery, the epithelium reduces the number of epithelial cells to return to the original state. Understanding the mechanisms involved in this resolution could be useful in deleting mucous cells and, thereby, mucous secretions. We have found that metaplastic mucous cells induced by exposure to ozone, endotoxin, cigarette smoke or allerg...
Equine recurrent airway obstruction: pathogenesis, diagnosis, and patient management.
The Veterinary clinics of North America. Equine practice    January 9, 2003   Volume 18, Issue 3 453-vi doi: 10.1016/s0749-0739(02)00026-3
Davis E, Rush BR.Recurrent airway obstruction is a condition that affects some older horses maintained in confinement. Clinical signs range from exercise intolerance with occasional cough to dyspnea at rest. Bronchoalveolar lavage cytology is characterized by neutrophilic leukocytosis (15%-85%) and is recommended for making the diagnosis in horses with mild to moderate disease. Environmental management combined with periodic bronchodilator and antiinflammatory corticosteroid therapy yields the best prognosis for disease remission.
Innervation of equine airways.
Pulmonary pharmacology & therapeutics    December 21, 2002   Volume 15, Issue 6 503-511 doi: 10.1006/pupt.2002.0390
Matera MG, Amorena M, Lucisano A.Equine obstructive pulmonary disease (COPD), or heaves or recurrent airway obstruction, is a common equine pulmonary disease similar to human asthma and/or CODP. Since bronchospasm and inflammation are the key features in heaves, the purpose of this paper is to review the contribution of neural mechanism that may be relevant to this disease. Equine airway receive cholinergic and adrenergic innervation, as well as observed in many species. It was suggested that the autonomic neural control in asthma might be defective with an imbalance between excitatory and inhibitory pathways, resulting in ex...