Intradermal testing of horses with and without insect bite hypersensitivity in The Netherlands using an extract of native Culicoides species.

Intradermal tests using a Culicoides nubeculosus extract have proven unreliable for diagnosis of equine insect bite hypersensitivity (IBH) in the Netherlands. The aim of this study was to evaluate the diagnostic value of an extract derived from the Dutch species C. obsoletus and C. pulicaris. Thirteen pairs of horses were tested, each pair consisting of one horse with IBH and the other a healthy control. Each horse was injected intradermally with 0.1 mL of three concentrations of Culicoides whole body extract (1 : 1000 w/v, 1 : 10,000 w/v and 1 : 25,000 w/v), histamine solution (0.01 mg/mL, positive control) and phosphate-buffered saline (negative control). Skin responses were evaluated after 30 min and at 1, 4 and 24 h. At all time points the absolute wheal diameter elicited by Culicoides extract 1 : 1000 w/v was significantly larger (P < 0.01) in the IBH horses than in the control horses. Using the 1 : 10,000 w/v extract the difference was significant at 1, 4 and 24 h and using the 1 : 25,000 w/v extract only at 24 h. The relative wheal diameter was greater in IBH than in control horses at all concentrations and time points except at 0.5 h for the 1 : 10,000 w/v and 1 : 25,000 w/v concentrations. At the 1 : 1000 w/v concentration, the sensitivity and specificity was 92% using the relative wheal diameter. These results indicate that intradermal testing using 1 : 1000 w/v concentration Culicoides extracts relevant to the locality provides useful support for a clinical diagnosis of equine insect hypersensitivity.