Stepnik Casey T, Outerbridge Catherine A, White Stephen D, Kass Philip H
Department of Medicine, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
Vet Dermatol. 2012 Feb;23(1):29-35, e7. doi: 10.1111/j.1365-3164.2011.01001.x. Epub 2011 Jul 21.
This retrospective study reports on the clinical presentation of equine atopic skin disease and evaluates response to treatment with allergen-specific immunotherapy (ASIT) based on intradermal testing and/or serum testing. Computerized medical records from January 1991 to December 2008 yielded 54 horses included in the study. Presenting clinical signs (CS) included urticaria (n=28), pruritus (n=8) or both (n=18). Forty-one of 54 horses received ASIT, and response to ASIT (n=32) was evaluated via telephone survey. Eighty-four per cent (n=27) of owners reported that ASIT reduced their horse's CS; 59% (n=19) were able to manage CS by ASIT alone. Three horses (9%) were managed with ASIT in combination with doxepin and discontinued use of corticosteroids. There was no statistical significance between type of test performed and reported success of ASIT (χ(2) analysis, P=0.53). Ninety-three per cent (n=30) of owners reported use of antipruritic medications prior to starting ASIT; 57% (n=17) of these owners reported discontinuing those medications due to success of ASIT. Adverse effects were limited to swelling at the injection site, seen in 16% (n=5). Seventy-five per cent (n=24) of owners elected to discontinue ASIT after 6 months to 8 years (mean 2.2 years): 15 due to resolution of CS, six due to persistent CS, two because the horse was sold, and one due to cost. Ten owners reported no recurrence of CS after discontinuing ASIT; five had recurrence within a median of 2 years of discontinuing ASIT (range 1-12 years). Allergen-specific immunotherapy is a safe and effective way to manage equine atopic skin disease.
这项回顾性研究报告了马过敏性皮肤病的临床表现，并基于皮内试验和/或血清试验评估了过敏原特异性免疫疗法（ASIT）的治疗效果。1991年1月至2008年12月的计算机化病历中筛选出54匹马纳入研究。呈现的临床症状（CS）包括荨麻疹（n = 28）、瘙痒（n = 8）或两者皆有（n = 18）。54匹马中有41匹接受了ASIT，并通过电话调查评估了对ASIT的反应（n = 32）。84%（n = 27）的马主报告称ASIT减轻了他们马匹的临床症状；59%（n = 19）的马主仅通过ASIT就能控制临床症状。3匹马（9%）通过ASIT联合多塞平进行治疗，并停用了皮质类固醇。所进行的检测类型与报告的ASIT成功与否之间无统计学意义（χ²分析，P = 0.53）。93%（n = 30）的马主报告在开始ASIT之前使用过止痒药物；其中57%（n = 17）的马主报告由于ASIT成功而停用了这些药物。不良反应仅限于注射部位肿胀，16%（n = 5）的马匹出现此情况。75%（n = 24）的马主在6个月至8年（平均2.2年）后选择停止ASIT：15例是因为临床症状缓解，6例是因为临床症状持续存在，2例是因为马匹售出，1例是因为费用问题。10位马主报告在停止ASIT后临床症状未复发；5例在停止ASIT后的中位数2年（范围1 - 12年）内复发。过敏原特异性免疫疗法是治疗马过敏性皮肤病的一种安全有效的方法。
