Discrepancies in the bilateral intradermal test and serum tests in atopic horses.
Abstract: In equine atopic patients intradermal testing (IDT) and immunoglobulin (Ig)E serology are used frequently. There is little evidence regarding the reproducibility of the IDT and IgE serology in horses. Objective: To compare the results of a simultaneously performed IDT on the left and right side of the neck in atopic horses, and to compare these results with allergen-specific IgE serology. Methods: Ten equine patients from a university hospital population with chronic urticaria and/or pruritus. Methods: The IDT was performed using 16 allergens and the results were evaluated after 30 min, 1, 4 and 24 h. Thirteen allergens also were analysed in duplicate with two monoclonal allergen-specific IgE enzyme-linked immunosorbent assays (ELISA). Results: Good agreement (Kappa > 0.6) between left and right IDT was found only for Dermatophagoides farinae, Lepidoglyphus destructor, birch pollen mixture and perennial rye at 30 min, birch pollen mixture at 1 h, and Acarus siro and nettle and common mugwort mixture at 4 h. The bilateral comparison of the other allergens and even the same allergens at other time points showed little or no concordance between left and right IDT. The interlaboratory comparison between both ELISAs, and the comparison between the ELISAs and IDT, showed a good agreement for two of 13 allergens: D. farinae and Dermatophagoides pteronyssinus. Conclusions: Based on these preliminary data, IDT and IgE serological test results should be interpreted with great care and further studies are needed to indicate the clinical relevance of these findings. Background: Chez les chevaux atopiques, les tests intradermiques (IDR) et la sérologie immunoglobuline (Ig)E sont souvent utilisés. Il y a peu de preuve concernant la reproductibilité des IDT et de la sérologie IgE chez le cheval. Objective: Comparer les résultats d’IDR réalisés simultanément sur les faces droite et gauche du cou de chevaux atopiques et comparer ces résultats avec une sérologie IgE spécifique d’allergènes. Unassigned: Dix chevaux d’un hôpital universitaire avec urticaire chronique et/ou prurit. MATÉRIELS ET MÉTHODES: Les IDR ont été réalisés avec 16 allergènes et les résultats ont été évalués après 30 min, 1, 4 et 24h. Treize allergènes ont aussi été analysés en duplicata avec deux tests ELISA IgE monoclonaux spécifiques d’allergènes. RÉSULTATS: Une bonne concordance (Kappa > 0.6) entre les IDR droit et gauche a été trouvée pour Dermatophagoides farinae, Lepidoglyphus destructor, le pollen de bouleau et le seigle vivace à 30 min, le mélange de pollen de bouleau à 1h, et Acarus siro, l’ortie et l’armoise à 4 h. La comparaison bilatérale des autres allergènes et aussi, des mêmes allergènes à d’autres moments ont montré peu ou pas de concordance entre les IDR droit et gauche. La comparaison inter laboratoire entre les deux tests ELISA et la comparaison entre les ELISA et les IDR, a montré une bonne concordance pour deux des 13 allergènes : D. farinae and Dermatophagoides pteronyssinus. Unassigned: A partir de ces données préliminaires, les IDR et les tests sérologiques d’IgE devraient être interprétés avec précaution et des études supplémentaires sont nécessaires pour indiquer la signification clinique de ces données. INTRODUCCIÓN: en pacientes atópicos equinos, las pruebas intradérmicas (IDT) y la serología de inmunoglobulina (Ig) E se usan con frecuencia. Hay poca evidencia con respecto a la reproducibilidad de IDT y serología de IgE en caballos. OBJETIVOS: comparar los resultados de una IDT realizada simultáneamente en el lado izquierdo y derecho del cuello en caballos atópicos, y comparar estos resultados con la serología de IgE específica para alérgenos. ANIMALES: diez pacientes equinos de una población de un hospital universitario con urticaria crónica y/o prurito. MÉTODOS Y MATERIALES: la IDT se realizó con 16 alérgenos y los resultados se evaluaron después de 30 min, 1, 4 y 24 h. También se analizaron trece alérgenos por duplicado en pruebas con dos anticuerpos monoclonales para IgE específicos de alergeno inmunoabsorbidos y ligados a enzima (ELISA). RESULTADOS: se observó buena concordancia (Kappa> 0,6) entre IDT izquierda y derecha solo para Dermatophagoides farinae, Lepidoglyphus destructor, mezcla de polen de abedul y centeno perenne a los 30 min, mezcla de polen de abedul a 1 h, y Acarus siro y mezcla de ortiga y ajenjo común a las 4 h. La comparación bilateral de los otros alérgenos e incluso de los mismos alérgenos en otros puntos temporales mostró poca o ninguna concordancia entre la IDT izquierda y derecha. La comparación entre laboratorios entre ambos ELISA, y la comparación entre los ELISA y la IDT, mostró una buena correlación para dos de los 13 alérgenos: D. farinae y Dermatophagoides pteronyssinus. CONCLUSIONES E IMPORTANCIA CLÍNICA: en base a estos datos preliminares, los resultados de las pruebas serológicas IDT e IgE deben interpretarse con gran cuidado y se necesitan más estudios para indicar la relevancia clínica de estos hallazgos. Unassigned: Bei Pferdepatienten mit Atopie wird häufig der Intradermaltest (IDT) und die Immunglobulin (Ig) E Serologie eingesetzt. Es gibt nur wenig Evidenz in Bezug auf die Reproduzierbarkeit des IDT und der IgE Serologie bei Pferden. Unassigned: Ein Vergleich der Ergebnisse simultan durchgeführter IDTs an der linken und an der rechten Seite des Nackens von atopischen Pferden, sowie ein Vergleich dieser Ergebnisse mit der Allergen-spezifischen IgE Serologie. Unassigned: Es wurden 10 Pferde der Population einer Universitätsklinik mit chronischen Urtikaria und/oder Pruritus verwendet. Unassigned: Der IDT wurde unter Verwendung von 16 Allergenen durchgeführt und die Ergebnisse nach 30 Minuten, 1, 4 und 24h evaluiert. Dreizehn Allergene wurden im Duplikat mit zwei monoklonalen Allergen-spezifischen IgE mittels Enzyme-linked-immunosorbent Assays (ELISA) analysiert. Unassigned: Es wurde nur eine gute Übereinstimmung (Kappa > 0,6) zwischen linkem und rechtem IDT bei Dermatophagoides farinae, Lepidoglyphus destructor, Birkenpollenmix und ganzjährigem Roggen nach 30 Minuten, Birkenpollenmix nach 1 h und Acarus siro und Nesseln sowie Gemeinem Beifuß Mix nach 4 h gefunden. Der bilaterale Vergleich der anderen Allergene und selbst dieselben Allergene zu anderen Zeitpunkten zeigten geringe oder keine Übereinstimmung zwischen linkem und rechtem IDT. Der Inter-Labor Vergleich zwischen den ELISAs und dem IDT zeigte eine gute Übereinstimmung für zwei der 3 Allergene: D. farinae und Dermatophagoides pteronyssinus. Unassigned: Die Ergebnisse des IDT und der IgE Serologie sollten, basierend auf diesen vorläufigen Daten, mit großer Sorgfalt interpretiert werden und es sind weitere Studien nötig, um die klinische Relevanz dieser Ergebnisse zu zeigen. 背景: アトピー馬では皮内検査(IDT)および免疫グロブリン(Ig)E血清学が頻繁に使用される。馬におけるIDTおよびIgE血清学の再現性に関する証拠はほとんどない。 目的: 本研究の目的は、アトピー馬の首の左右で同時に行われたIDT結果を比較し、これらの結果をアレルゲン特異的IgE血清学と比較することであった。 被験動物: 慢性蕁麻疹および/または瘙痒症を有する大学病院の10頭の馬。 材料と方法: IDTは16のアレルゲンを使用して実行され、結果は30分、1、4、24時間後に評価された。 13種類のアレルゲンも、2つのモノクローナルアレルゲン特異的IgE酵素免疫測定法(ELISA)によって2重に解析した。 結果: 左右IDT間の良好な一致(カッパ> 0.6)は、30分後のDermatophagoides farinae、Lepidoglyphus destructor、シラカバ花粉混合物および多年生ライ麦で、1時間後のシラカバ花粉混合物、そして4時間後のアシブトコナダニ、イラクサおよびヨモギ混合物でのみ認められた。他のアレルゲンと他の時点での同じアレルゲンの両側間比較では、左右のIDT間にほとんどまたはまったく一致が見られなかった。両ELISA間の実験室間比較、そしてELISAおよびIDT間の比較は、13種類のアレルゲンのうち2つ(D. farinaeおよびDermatophagoides pteronyssinus)について良好な一致を示した。 結論と臨床的重要性: これらの予備データに基づいて、IDTおよびIgE血清学的検査結果は細心の注意を払って解釈されるべきであり、これらの発見の臨床的関連性を示すためにさらなる研究が必要である。. 背景: 皮内试验(IDT)和免疫球蛋白 (Ig)E血清学试验经常用于异位性患马。关于马的IDT和IgE血清学试验结果重复性的证据很少。 目的: 比较同时对异位性患马颈部左侧和右侧进行IDT的结果,并将这些结果与过敏原特异性IgE血清学试验进行比较。 动物: 来自大学医院的10例患有慢性荨麻疹和/或瘙痒的马。 方法和材料: 使用16种过敏原进行IDT,并在30min、1、4和24h后评价结果。还使用两种单克隆过敏原特异性IgE酶联免疫吸附试验 (ELISA)对13种过敏原进行重复性分析。 结果: 左右IDT一致性良好(Kappa>0.6)仅见于30min的粉尘螨、鳞翅目昆虫、桦树花粉混合物和多年生黑麦,1h的桦树花粉混合物,4h的粗脚粉螨和荨麻以及普通艾蒿混合物,其他过敏原甚至相同过敏原在其他时间点的双侧比较显示左右IDT之间几乎不一致。两种ELISA的实验室间比较,以及ELISA与IDT之间的比较,显示在13种过敏原中的2种:粉尘螨和屋尘螨有很好的一致性。 结论和临床重要性: 基于这些初步数据,应谨慎判断IDT和IgE血清学检测结果,需要进一步研究来表明这些结果的临床相关性。. Unassigned: Em pacientes equinos atópicos, os testes intradérmico (IDT) e sorológico (pesquisa de IgE) são utilizados com frequência. Há poucas evidências sobre a concordância do IDT e da sorologia em cavalos. Objective: Comparar os resultados de IDT realizado simultaneamente no lado esquerdo e direito do pescoço em cavalos atópicos e comparar esses resultados com a sorologia para IgE alérgenos-específica. Unassigned: Dez pacientes equinos oriundos da população de um hospital universitário apresentando urticária crônica e/ou prurido. MÉTODOS E MATERIAIS: O IDT foi realizado utilizando 16 alérgenos e os resultados foram avaliados após 30 min, 1, 4 e 24 h. Treze alérgenos foram também analisados em duplicata por dois ensaios de imunoenzimáticos com anticorpos IgE alérgenos-específicas monoclonais (ELISA). Results: Observou-se boa concordância (Kappa> 0,6) entre IDT esquerda e direita apenas para Dermatophagoides farinae, Lepidoglyphus destructor, mix de pólen de bétula e centeio perene aos 30 min, mix de pólen de bétula à 1 h, e Acarus siro e urtiga e mix de artemísia às 4 h. A comparação bilateral dos outros alérgenos e até dos mesmos alérgenos em outros tempos experimentais mostrou pouca ou nenhuma concordância entre o IDT esquerdo e direito. A comparação interlaboratorial entre os dois ELISA, e a comparação entre os ELISA e o IDT, mostrou uma boa concordância para dois dos 13 alérgenos: D. farinae e Dermatophagoides pteronyssinus. CONCLUSÕES E IMPORTÂNCIA CLÍNICA: Com base nesses dados preliminares, os resultados dos testes sorológico e IDT devem ser interpretados com muito cuidado e são necessários mais estudos para indicar a relevância clínica desses achados.
© 2020 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the European Society of Veterinary Dermatology and the American College of Veterinary Dermatology.
Publication Date: 2020-08-03 PubMed ID: 32743929PubMed Central: PMC7589420DOI: 10.1111/vde.12871Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Allergies
- Clinical Examination
- Clinical Study
- Clinical Symptoms
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease
- Disease Diagnosis
- Enzyme-Linked Immunosorbent Assay (ELISA)
- Equine Diseases
- Equine Health
- Horses
- Immunoglobulin E
- Immunology
- In Vitro Research
- In Vivo
- Laboratory Methods
- Veterinary Care
- Veterinary Medicine
- Veterinary Research
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research investigates the coherence of intradermal tests (IDT) and immunoglobulin (Ig)E serology tests in diagnosing atopic conditions (allergies) in horses. Results revealed discrepancies between the left and right IDT and also between IDT and IgE tests, suggesting that these tests should be interpreted with caution and further studies are needed to improve reliability.
Objective and Methodology
- The prime objective of this study was to examine the concordance of IDT performed on the left and right sides of the neck in atopic horses and to compare these results with allergen-specific IgE serology tests.
- It involved a sample of ten equine patients from a university hospital, all of whom displayed symptoms of chronic urticaria (hives) and/or pruritus (itching).
- Each horse was subjected to IDT on both sides of the neck using 16 allergens and the results were evaluated at different time intervals: 30 minutes, 1 hour, 4 hours and 24 hours after the procedure.
- Thirteen allergens were also double-checked by running two separate monoclonal allergen-specific IgE ELISA tests in parallel.
Results
- The study found significant agreement (Kappa > 0.6) between left and right IDT for Dermatophagoides farinae, Lepidoglyphus destructor, birch pollen mixture and perennial rye at the 30 minute time point.
- Good agreement was also found for birch pollen mixture at 1 hour, and Acarus siro and a mixture of nettle and common mugwort at 4 hours.
- However, for other allergens and different time points, there was little to no concordance between the left and right IDT results.
- There was also good agreement for two of the thirteen allergens between ELISA results and IDT, specifically D. farinae and Dermatophagoides pteronyssinus.
Conclusions
- Based on these preliminary findings, caution is recommended when interpreting the results from IDT and IgE serological tests.
- The authors advocate further studies to clarify the clinical implications of these disparities and to improve the appraisal of test results.
Cite This Article
APA
van Damme CMM, van den Broek J, Sloet van Oldruitenborgh-Oosterbaan MM.
(2020).
Discrepancies in the bilateral intradermal test and serum tests in atopic horses.
Vet Dermatol, 31(5), 390-e104.
https://doi.org/10.1111/vde.12871 Publication
Researcher Affiliations
- Department Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht NL, 3584 CM, The Netherlands.
- Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, Utrecht NL, 3584 CM, The Netherlands.
- Department Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, Utrecht NL, 3584 CM, The Netherlands.
MeSH Terms
- Allergens
- Animals
- Dermatitis, Atopic / diagnosis
- Dermatitis, Atopic / veterinary
- Horse Diseases / diagnosis
- Horses
- Immunoglobulin E
- Intradermal Tests / veterinary
- Reproducibility of Results
Grant Funding
- ArtuVet Animal Health B.V., Lelystad, the Netherlands
References
This article includes 26 references
- Scott DW, Miller WH. Equine Dermatology, 2nd edition. Maryland Heights, MO: Saunders Elsevier, 2011: 263–313.
- Marsella R, De Benedetto A. Atopic dermatitis in animals and people: an update and comparative review.. Vet Sci 2017; 4: 37.
- Loeffler A, Herrick D, Allen S. Long‐term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions.. Vet Dermatol 2018; 29: 526–e176.
- Fadok VA. Update on equine allergies.. Vet Clin North Am Equine Pract 2013; 29: 541–550.
- Jose‐Cunilleras E, Kohn CW, Hillier A. Intradermal testing in healthy horses and horses with chronic obstructive pulmonary disease, recurrent urticaria, or allergic dermatitis.. J Am Vet Med Assoc 2001; 219: 1,115–1,121.
- Lebis C, Bourdeau P, Marzin‐Keller F. Intradermal skin tests in equine dermatology: a study of 83 horses.. Equine Vet J 2002; 34: 666–671.
- Lorch G, Hillier A, Kwochka KW. Results of intradermal tests in horses without atopy and horses with atopic dermatitis or recurrent urticaria.. Am J Vet Res 2001; 62: 1,051–1,059.
- Lorch G, Hillier A, Kwochka KW. Comparison of immediate intradermal test reactivity with serum IgE quantitation by use of a radioallergosorbent test and two ELISA in horses with and without atopy.. J Am Vet Med Assoc 2001; 218: 1,314–1,322.
- Morgan EE, Miller WH, Wagner B. A comparison of intradermal testing and detection of allergen‐specific immunoglobulin E in serum by enzyme‐linked immunosorbent assay in horses affected with skin hypersensitivity.. Vet Immunol Immunopathol 2007; 120: 160–167.
- Stepnik CT, Outerbridge CA, White SD. Equine atopic skin disease and response to allergen‐specific immunotherapy: a retrospective study at the University of California‐Davis (1991–2008).. Vet Dermatol 2012; 23: 29–e7.
- Radwanski NE, Morris DO, Boston RC. Longitudinal evaluation of immunological responses to allergen‐specific immunotherapy in horses with IgE associated dermatological disease, a pilot study.. Vet Dermatol 2019; 30: 255–e78.
- Marsella R. Equine allergy therapy: update on the treatment of environmental, insect bite hypersensitivity, and food allergies.. Vet Clin North Am Equine Pract 2013; 29: 551–557.
- Lee KW, Blankenship KD, McCurry ZM. Performance characteristics of a monoclonal antibody cocktail‐based ELISA for detection of allergen‐specific IgE in dogs and comparison with a high affinity IgE receptor‐based ELISA.. Vet Dermatol 2009; 20: 157–164.
- Wilson AD, Harwood L, Torsteinsdottir S. Production of monoclonal antibodies specific for native equine IgE and their application to monitor total serum IgE responses in Icelandic and non‐Icelandic horses with insect bite dermal hypersensitivity.. Vet Immunol Immunopathol 2006; 112: 156–170.
- Dohoo IR, Martin W, Stryhn H. Veterinary Epidemiologic Research. Charlottetown, Canada: AVC Inc., 2003:616–623.
- Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation.. Anest Analg 2018; 126: 1,763–1,768.
- Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic.. Fam Med 2005; 37: 360–363.
- Sloet van Oldruitenborgh‐Oosterbaan MM, Noli C, Van De Knaap J. Intradermal allergy testing in normal horses. Advances in Veterinary Dermatology volume 3 Butterworth‐Heinemann, Oxford; 1998: 564–565 (abstract).
- Baxter CG, Vogelnest LJ. Determination of threshold concentrations of multiple allergenic extracts for equine intradermal testing using normal horses in three seasons.. Vet Dermatol 2008; 19: 305–313.
- Lane MJ, Pucheu‐Haston CM, Kearney MT. Determination of irritant threshold concentrations of multiple tree, grass, weed and mould allergens for intradermal testing of horses residing in the southern USA.. Vet Dermatol 2017; 28: 604–e147.
- Bodtger U, Jacobsen CR, Poulsen LK. Long‐term repeatability of the skin prick test is high when supported by history or allergen‐sensitivity tests: a prospective clinical study.. Allergy 2003; 58: 1,180–1,186.
- Wallace JC, Vogelnest LJ. Evaluation of the presence of house dust mites in horse rugs.. Vet Dermatol 2010; 21: 602–607.
- Roberts HA, Hurcombe SD, Hillier A. Equine intradermal test threshold concentrations for house dust mite and storage mite allergens and identification of stable acari fauna.. Vet Dermatol 2014; 25: 124–126.
- Hillier A, DeBoer DJ. The ACVD task force on canine atopic dermatitis (XVII): intradermal testing.. Vet Immunol Immunopathol 2001; 81: 289–304.
- Thom N, Favrot C, Failing K. Intra‐ and interlaboratory variability of allergen‐specific IgE levels in atopic dogs in three different laboratories using the Fc‐epsilon receptor testing.. Vet Immunol Immunopathol 2010; 133: 183–189.
- Foster AP, Littlewood JD, Webb P. Comparison of intradermal and serum testing for allergen‐specific IgE using a Fcepsilon RIalpha‐based assay in atopic dogs in the UK.. Vet Immunol Immunopathol 2003; 93: 51–60.
Citations
This article has been cited 1 times.- Pessoa VC, Branco-Ferreira M, Jónsdóttir S, Marti E, Tilley P. Comparison of Skin Prick Tests (SPT), Intradermal Tests (IDT) and In Vitro Tests in the Characterization of Insect Bite Hypersensitivity (IBH) in a Population of Lusitano Horses: Contribution for Future Implementation of SPT in IBH Diagnosis. Animals (Basel) 2023 Aug 28;13(17).
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists