Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome

A special issue of Animals (ISSN 2076-2615). This special issue belongs to the section "Equids".

Deadline for manuscript submissions: closed (20 June 2024) | Viewed by 15483

Special Issue Editors


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Guest Editor
1. Equine Clinical Academic Division, Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
2. Clinical Research Laboratory, Centre for Interdiciplinary Research in Animal Health (CIISA), 1300-477 Lisbon, Portugal
Interests: equine asthma; respiratory; sport medicine; laryngeal dysfunction
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Clinical Research Laboratory, Centre for Interdiciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
Interests: respiratory medicine; equine dynamic upper airway obstruction; sport medicine; equine asthma; allergy
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Faculty of Veterinary Medicine, Universidade Lusófona, 1749-024 Lisboa, Portugal
2. Faculdade de Medicina Veterinária, CIISA-Centro de Investigação Interdisciplinar em Sanidade Animal, Universidade de Lisboa, 1300-477 Lisboa, Portugal
Interests: antimicrobial resistance; veterinary microbiology; molecular epidemiology of urinary tract pathogens; veterinary medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, there has been an increase in the diagnosis of asthma-like diseases in both humans and animals, and horses are no exception.

Severe equine asthma is a highly prevalent chronic respiratory disease, and despite having first been described several hundred years ago, many of its aspects remain unclear. The precise genetic and immune mechanisms of the disease are not fully understood, and the current knowledge gap hinders the development of novel therapeutic targets.

Additionally, the development of non-invasive biomarkers for diagnosing and monitoring disease progression is a promising research field, and its pursuit could also provide valuable alternative therapeutic options, with the potential to drastically improve affected horses’ clinical management.

Thus, these areas constitute crucial research fields, which is why Animals is publishing a Special Issue highlighting the recent scientific advances in this subject. Researchers are invited to contribute to “Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome” in the form of original research articles, reviews, and viewpoints, among other relevant scientific communications. We hope that this will constitute a useful tool in the progression of scientific knowledge on equine respiratory disease.

Dr. Joana Simões
Dr. Paula Tilley
Dr. Cátia Marques
Guest Editors

Manuscript Submission Information

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Keywords

  • equine
  • asthma
  • lung
  • inflammation
  • chronic
  • diagnosis
  • therapy
  • genetic
  • immunology
  • respiratory

Published Papers (10 papers)

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Research

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21 pages, 2420 KiB  
Article
Antimicrobial Prescription Behavior in Equine Asthma Cases: An International Survey
by Astrid J. van den Brom-Spierenburg, Alexandra N. Mureșan and Cornélie M. Westermann
Animals 2024, 14(3), 457; https://doi.org/10.3390/ani14030457 - 30 Jan 2024
Viewed by 1774
Abstract
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 [...] Read more.
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 respondents confirmed national regulations concerning antimicrobial use in their country. Knowledge of the asthma definitions as presented in the revised ACVIM consensus statement was greater in veterinarians treating over 95% of equine patients compared to veterinarians treating more species, based on 10 questions (answers consistent with the consensus statement in 7 (IQR 5–9) and 4 (IQR 3–6) questions, respectively, (p < 0.001)). A total of 131 respondents stated to use antimicrobials (at least ‘sometimes’) in at least one of the three presented cases consistent with equine asthma. Trimethoprim-Sulfa combinations, penicillin(s), and tetracyclines were prescribed most (by 105, 53 and 38 veterinarians, respectively). Aminoglycosides, cephalosporins and fluoroquinolones were also selected (22, 15, 9 veterinarians respectively). Tetracyclines and cephalosporins are prescribed more often by veterinarians working without national regulations (p 0.019 and p 0.035, respectively). The most selected factors influencing prescription behavior were: ‘tracheal wash culture’ (62% of 131 veterinarians using antimicrobials in these cases), ‘whether other horses in the barn have similar complaints’ (60%), and ‘response to other forms of therapy’ (53%). In conclusion, insight into prescription behavior is the first step towards minimizing and optimizing antimicrobial use. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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19 pages, 786 KiB  
Article
A Longitudinal Analysis of Equine Asthma Presentation and Response to Treatment Using Lung Function Testing and BAL Cytology Analysis in Combination with Owner Perception
by Tyler-Jane Robins, Daniela Bedenice and Melissa Mazan
Animals 2023, 13(21), 3387; https://doi.org/10.3390/ani13213387 - 1 Nov 2023
Viewed by 1308
Abstract
(1) Background: Equine asthma (EA) is a pervasive and important cause of poor performance and respiratory morbidity in horses. Diagnosis of EA includes an owner complaint, clinical scoring, lung function testing, and cytological analysis of bronchoalveolar lavage (BAL) cytology. There is a paucity [...] Read more.
(1) Background: Equine asthma (EA) is a pervasive and important cause of poor performance and respiratory morbidity in horses. Diagnosis of EA includes an owner complaint, clinical scoring, lung function testing, and cytological analysis of bronchoalveolar lavage (BAL) cytology. There is a paucity of information about the longitudinal course of the disease using these outcome assessments; thus, this study sought to describe and quantify, in horses with more than one visit to a specialty pulmonary clinic in New England, the type and range of clinical presentations with an eventual diagnosis of EA. It also aimed to develop and compare the outcomes of scoring systems for owner complaints and veterinary assessments, document and assess the diagnostic methods used, and evaluate the response of the horses to treatment and time. (2) Methods: This study was a retrospective, cross-sectional, STROBE-compliant observational analysis of equine patients who visited the Tufts Cummings Hospital for Large Animals (HLA) for evaluation of equine asthma (EA) from 1999–2023. The horses were categorized as having mild–moderate (mEA) or severe EA (sEA) using the ACVIM consensus statement guidelines. After excluding those with inadequate documentation or only one visit (n = 936), a total of 76 horses were included in the study. Of the 197 visits, 138 (70.0%) resulted in a diagnosis of mEA and 45 (22.8%) resulted in a diagnosis of sEA. Demographic information, owner complaints, clinical examination and scoring, lung function testing, BAL cytology, and recommendations for environmental remediation and pharmacologic treatment were recorded for all the visits. The data were analyzed for agreement between owner complaints (complaint score, CS) and clinical examination findings (examination score, ES), changes in CS and ES, lung function testing, and BAL cytology over time, with 197 visits recorded. (3) Results: A comparison between the CS and ES showed that the owners were more likely than veterinarians to detect cough, and a decrease in cough was the most common owner observation after treatment. The response to the histamine challenge, used to detect airway hyperreactivity, was significantly improved with treatment or time in the horses with mEA, whereas baseline lung function did not significantly change in mEA or sEA. (4) Conclusions: Owners can be astute observers of clinical signs, especially cough, in EA. Tests of airway hyperreactivity are more successful in detecting changes in mEA than are baseline lung function testing and assessment of BAL cytology. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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12 pages, 2230 KiB  
Article
Effect of Lavage Solution Type on Bronchoalveolar Lavage Fluid Cytology in Clinically Healthy Horses
by Cornélie M. Westermann, Annelieke G. de Bie, Carla Olave, Janny C. de Grauw, Erik Teske and Laurent L. Couetil
Animals 2023, 13(16), 2637; https://doi.org/10.3390/ani13162637 - 15 Aug 2023
Viewed by 2752
Abstract
Equine bronchoalveolar lavage (BAL) is usually performed with 250–500 mL of isotonic saline at pH 5.5. The acidic pH of saline may cause an increase in airway neutrophil count 48 h after BAL. Other isotonic solutions such as Ringer’s solution, phosphate-buffered saline (PBS) [...] Read more.
Equine bronchoalveolar lavage (BAL) is usually performed with 250–500 mL of isotonic saline at pH 5.5. The acidic pH of saline may cause an increase in airway neutrophil count 48 h after BAL. Other isotonic solutions such as Ringer’s solution, phosphate-buffered saline (PBS) or Plasma-Lyte 148® have a neutral pH of 7.4 and might be a better choice for BAL by not provoking inflammation and the influx of neutrophils into airways. BAL was performed in four healthy horses in four different lung lobes using four different solutions in a randomized crossover design. In each lobe, BAL was performed twice with a 48 h interval using 250 mL of solution. Automated total nucleated cell counts (TNCs) were recorded, and differential cell counts in lavage fluid were determined by two investigators blinded to treatments. The mean volume of BAL fluid retrieved was 51 ± 14%. The mean neutrophil percentage (%N) increased from 1.5 ± 0.9% to 14.7 ± 9.6% at 48 h (p < 0.001) but was not significantly affected by the solution used or the lung lobe sampled. In conclusion, in this study, the influx of neutrophils into airways after BAL was independent of the type of isotonic solution used and the lung lobe sampled. Saline remains an appropriate solution for BAL in horses. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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16 pages, 1685 KiB  
Article
Airway Hyperresponsiveness, but Not Bronchoalveolar Inflammatory Cytokines Profiles, Is Modified at the Subclinical Onset of Severe Equine Asthma
by Thibault Frippiat, Tatiana Art and Irene Tosi
Animals 2023, 13(15), 2485; https://doi.org/10.3390/ani13152485 - 1 Aug 2023
Viewed by 1721
Abstract
Airway hyperresponsiveness (AHR) and inflammation are both observed in human and equine asthma. The aim of this study was to assess the timeline and relationship of both features at the subclinical onset of severe equine asthma (SEA). First, the repeatability of the pulmonary [...] Read more.
Airway hyperresponsiveness (AHR) and inflammation are both observed in human and equine asthma. The aim of this study was to assess the timeline and relationship of both features at the subclinical onset of severe equine asthma (SEA). First, the repeatability of the pulmonary function test (PFT) using impulse oscillometry system, and the methacholine bronchoprovocation test (BPT) were assessed at a 1-day interval on six SEA horses in clinical remission and six control horses. Then, clinical and ancillary tests were performed before and after a 1-week low-dust environmental challenge, including weighted clinical score, respiratory endoscopy, bronchoalveolar fluid cytology, PFT, and BPT. Both PFT and BPT showed acceptable repeatability. No test allowed SEA horses in clinical remission to be distinguished from control, unlike in human patients. Because of the low-dust environment, no significant difference was observed in the results of clinical and conventional ancillary examinations after the challenge. However, SEA horses showed increased AHR after the environmental challenge. At that stage, no signs of inflammation or changes in pro-inflammatory cytokines profiles (quantification and gene expression) were observed, suggesting AHR is present at an earlier stage of equine asthma than airway inflammation. This feature indicates SEA could present in a different disease pathway than neutrophilic human asthma. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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17 pages, 1472 KiB  
Article
Co-Occurrence of Severe Equine Asthma and Palatal Disorders in Privately Owned Pleasure Horses
by Natalia Kozłowska, Małgorzata Wierzbicka, Bartosz Pawliński and Małgorzata Domino
Animals 2023, 13(12), 1962; https://doi.org/10.3390/ani13121962 - 12 Jun 2023
Viewed by 1437
Abstract
According to the “unified or united airway disease” theory, diseases in the upper and lower airways frequently co-occur because they represent a single morphological and functional unit. Palatal disorders (PDs) and severe equine asthma (SEA) are frequent diseases that, respectively, affect upper and [...] Read more.
According to the “unified or united airway disease” theory, diseases in the upper and lower airways frequently co-occur because they represent a single morphological and functional unit. Palatal disorders (PDs) and severe equine asthma (SEA) are frequent diseases that, respectively, affect upper and lower equine airways; however, clinical studies focusing on the co-occurrence of PDs and SEA are limited. The present study investigated the prevalence of PDs in horses affected by SEA, and whether prevalence decreased after SEA treatment. Forty-six privately owned horses affected by SEA in exacerbation were included. For each horse, the severity of the asthma clinical signs was assessed using a previously described scoring system, and the co-occurrence of palatal disorders was investigated using overground endoscopy, before and after treatment for SEA. Before treatment (in exacerbation), 67.4% of SEA-affected horses showed evidence of PDs, including 39.1% showing evidence of palatal instability (PI) and 28.3% of dorsal displacement of the soft palate (DDSP). Airway inflammation (neutrophil percentage in the tracheal wash and bronchoalveolar lavage fluid) was worse in horses with co-occurring PDs. After treatment (in remission), no horses showed evidence of PI, while DDSP was diagnosed in 8.7% of horses. These findings suggest that palatal disorders respond to asthma treatment, supporting the hypothesis that both diseases could be manifestation of a common underlying disorder. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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18 pages, 1261 KiB  
Article
Gene Expression Profiles of the Immuno-Transcriptome in Equine Asthma
by Elisa Padoan, Serena Ferraresso, Sara Pegolo, Carlo Barnini, Massimo Castagnaro and Luca Bargelloni
Animals 2023, 13(1), 4; https://doi.org/10.3390/ani13010004 - 20 Dec 2022
Cited by 1 | Viewed by 1357
Abstract
Background: Mild equine asthma (MEA) and severe equine asthma (SEA) are two of the most frequent equine airway inflammatory diseases, but knowledge about their pathogenesis is limited. The goal of this study was to investigate gene expression differences in the respiratory tract of [...] Read more.
Background: Mild equine asthma (MEA) and severe equine asthma (SEA) are two of the most frequent equine airway inflammatory diseases, but knowledge about their pathogenesis is limited. The goal of this study was to investigate gene expression differences in the respiratory tract of MEA- and SEA-affected horses and their relationship with clinical signs. Methods: Clinical examination and endoscopy were performed in 8 SEA- and 10 MEA-affected horses and 7 healthy controls. Cytological and microbiological analyses of bronchoalveolar lavage (BAL) fluid were performed. Gene expression profiling of BAL fluid was performed by means of a custom oligo-DNA microarray. Results: In both MEA and SEA, genes involved in the genesis, length, and motility of respiratory epithelium cilia were downregulated. In MEA, a significant overexpression for genes encoding inflammatory mediators was observed. In SEA, transcripts involved in bronchoconstriction, apoptosis, and hypoxia pathways were significantly upregulated, while genes involved in the formation of the protective muco-protein film were underexpressed. The SEA group also showed enrichment of gene networks activated during human asthma. Conclusions: The present study provides new insight into equine asthma pathogenesis, representing the first step in transcriptomic analysis to improve diagnostic and therapeutic approaches for this respiratory disease. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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Review

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15 pages, 904 KiB  
Review
Lipids in Equine Airway Inflammation: An Overview of Current Knowledge
by Jenni Mönki and Anna Mykkänen
Animals 2024, 14(12), 1812; https://doi.org/10.3390/ani14121812 - 18 Jun 2024
Viewed by 465
Abstract
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 [...] Read more.
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 in lipidomics have a broad variety of foci, of which fatty acid and lipid mediator profile analyses and global lipidomics have been implemented in veterinary medicine. As many crucial proinflammatory and proresolving mediators are lipids, lipidomic studies offer an interesting yet largely unexplored means to investigate inflammatory reactions in equine airways. The aim of this review article is to collect and summarize the findings of recent lipidomic studies on equine airway inflammation. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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18 pages, 320 KiB  
Review
Environmental Management of Equine Asthma
by Elisa Diez de Castro and Jose Maria Fernandez-Molina
Animals 2024, 14(3), 446; https://doi.org/10.3390/ani14030446 - 30 Jan 2024
Cited by 1 | Viewed by 1215
Abstract
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 [...] Read more.
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 forage used for feeding but also its method of production and possible contamination during manufacture and/or storage. Procedures to reduce this, such as soaking and steaming hay, improve its hygienic quality, although they also decrease forage’s nutritional value, making dietetic supplementation necessary. Regarding stabling, despite some conflicting results, avoiding straw as bedding and improving barn ventilation continue to be the common recommendations if turning to pasture is not feasible. Finally, owners’ compliance has been identified as the most critical point in correct environmental control. Educating owners about the genuine benefits of these measures should be a cornerstone of EA management. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
17 pages, 1275 KiB  
Review
Decision Making in Severe Equine Asthma—Diagnosis and Monitoring
by Joana Simões and Paula Tilley
Animals 2023, 13(24), 3872; https://doi.org/10.3390/ani13243872 - 16 Dec 2023
Cited by 2 | Viewed by 1669
Abstract
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. [...] Read more.
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 suitable for research purposes or lack practicality for everyday use. The aim of this paper is to assist the equine veterinarian in the process of decision making associated with managing SEA-affected patients. This review will focus on disease diagnosis and monitoring, while also presenting a flow-chart which includes the basic data that the clinician must obtain in order to accurately identify severely asthmatic horses in their everyday routine practice. It is important to note that European and American board-certified specialists on equine internal medicine can provide assistance in the diagnosis and treatment plan of SEA-affected horses. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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Other

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10 pages, 920 KiB  
Brief Report
Severely Asthmatic Horses Residing in a Mediterranean Climate Shed a Significantly Lower Number of Parasite Eggs Compared to Healthy Farm Mates
by Joana Simões, José Paulo Sales Luís, Luís Madeira de Carvalho and Paula Tilley
Animals 2023, 13(18), 2928; https://doi.org/10.3390/ani13182928 - 15 Sep 2023
Viewed by 804
Abstract
The relationship between helminth infection and allergic diseases has long intrigued the scientific community. This interaction was previously studied in a horse family with high incidence of severe equine asthma and in non-related severely asthmatic horses from equine hospital referrals in Switzerland. Our [...] Read more.
The relationship between helminth infection and allergic diseases has long intrigued the scientific community. This interaction was previously studied in a horse family with high incidence of severe equine asthma and in non-related severely asthmatic horses from equine hospital referrals in Switzerland. Our aim was to determine if this interaction would also be observed in a group of non-related client-owned severely asthmatic horses living in a Mediterranean climate and recruited through a first-opinion veterinarian group. Fecal samples from severe equine asthma-affected and healthy horses living in the same farms and subjected to identical environmental and deworming management were evaluated qualitatively and quantitatively. Strongyle-type eggs and Cyathostomum sensu latum larvae were the most abundant parasites in the studied population of horses; no significant differences between the groups were observed regarding the types of egg and infective larvae. However, we observed significant differences in the number of eggs and infective larvae per gram of feces shed, as this number was significantly lower in the SEA group than in the healthy horses. This may indicate that severely asthmatic horses have an intrinsic resistance to gastrointestinal helminths. Further studies in a larger population of horses are required to ascertain the immunological mechanisms responsible for these findings. Full article
(This article belongs to the Special Issue Advances in Equine Respiratory Disease: Severe Equine Asthma Syndrome)
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