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Equine Clinical Immunology > Chapter 16 RAO > Flashcards

Chapter 16 RAO Flashcards

1
Q

What is Recurrent Airway Obstruction (RAO) also known as?

A

Heaves and formerly as chronic obstructive pulmonary disease (COPD).

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2
Q

What environmental factors are associated with RAO?

A

Exposure to barn dusts and airborne antigens present at pasture.

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3
Q

What are the clinical signs of RAO and SPAOPD?

A

Respiratory distress at rest, bronchospasm, airway tissue remodeling, neutrophilic inflammation, and mucus secretions.

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4
Q

What is the mainstay treatment strategy for RAO?

A

Antigen avoidance strategies.

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5
Q

What are the common symptoms during an acute episode of RAO?

A

Increased expiratory effort, respiratory frequency, mild nasal discharge, flared nostrils, and markedly increased abdominal expiratory effort.

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6
Q

What is the ‘heaves line’?

A

Hypertrophy of the external abdominal oblique muscle due to strong and continuous respiratory effort.

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7
Q

What is the common age of onset for RAO?

A

Seven years of age or older.

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8
Q

Which breeds have a predisposition to RAO?

A

Thoroughbred horses and possibly other breeds, with females at greater risk than males.

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9
Q

What triggers the exacerbations of SPAOPD?

A

Exposure to high environmental counts of fungal spores and grass pollen grains during summer.

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10
Q

What are the primary immune cells involved in RAO?

A

Neutrophils.

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11
Q

What cytokines are increased in the bronchial epithelium of horses with RAO?

A

Interleukin-8 (IL-8).

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12
Q

What is the role of IL-17 in RAO?

A

Promotes neutrophil chemotaxis and activation.

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13
Q

What immune response is primarily associated with RAO?

A

A Th2 and Th17 driven immune response.

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14
Q

What is the significance of BALF in diagnosing RAO?

A

The presence of neutrophilic inflammation (usually >20%) in BALF cytology is a characteristic finding.

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15
Q

What environmental management strategies help control RAO?

A

Reducing exposure to dust, molds, and mites by changing food and bedding materials and increasing ventilation.

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16
Q

What are the common anti-inflammatory drugs used in RAO treatment?

A

Corticosteroids such as dexamethasone, prednisolone, and fluticasone.

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17
Q

What is the effect of bronchodilators in RAO treatment?

A

They relieve bronchospasm but do not have anti-inflammatory properties.

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18
Q

What are the genetic factors associated with RAO?

A

Genes associated with smooth muscle remodeling, leukotriene metabolism, and IL-4 receptor polymorphisms.

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19
Q

What is the role of corticosteroids in RAO treatment?

A

They control clinical signs and partially reverse tissue remodeling.

20
Q

What are the possible side effects of long-term corticosteroid use in horses?

A

Adrenocortical suppression, laminitis, hepatopathy, muscle wasting, altered bone metabolism, and increased susceptibility to infection.

21
Q

What are the potential triggers for RAO exacerbations?

A

Organic dust, fungal spores, moldy hay, grass pollen grains, and possibly viral infections.

22
Q

What is the role of IL-4 in RAO?

A

It activates neutrophils, promoting chemotaxis and inducing expression of inflammatory proteins.

23
Q

What are the effects of inhaled corticosteroids compared to systemic corticosteroids in RAO?

A

Inhaled corticosteroids have fewer systemic effects and are more targeted to the airways.

24
Q

What diagnostic tools are used to assess RAO?

A

Thoracic auscultation, BALF cytology, lung function testing, endoscopy, and radiographic studies.

25
Q

What is SPAOPD?

A

Summer Pasture-Associated Obstructive Pulmonary Disease, similar to RAO but associated with pasturing during summer.

26
Q

What is the prevalence of heaves in horses?

A

Heaves affects 10-20% of the adult equine population in temperate climates.

27
Q

What is the typical BALF cytology finding in RAO during exacerbation?

A

Predominantly neutrophils, often exceeding 20% of the cell population.

28
Q

What is the role of mast cells in RAO?

A

Mast cells are increased within the airway wall and contribute to inflammation by releasing histamine and other mediators.

29
Q

What are common clinical signs of severe RAO?

A

Extended head and neck positioning, flared nostrils, increased abdominal expiratory effort, and possibly fever and anorexia.

30
Q

What is the treatment approach during an acute RAO episode?

A

Immediate administration of bronchodilators and corticosteroids.

31
Q

What is the role of genetic predisposition in RAO?

A

Certain families and lineages are more susceptible, with identified genetic loci associated with the disease.

32
Q

What are the signs of RAO during remission?

A

Coughing episodes during exercise or eating, exercise intolerance, and possibly unremarkable thoracic auscultation.

33
Q

What is the effect of endotoxins on horses with RAO?

A

Endotoxins act as non-specific inflammatory stimuli, exacerbating the condition when combined with other antigens.

34
Q

What are the immunologic mechanisms involved in RAO?

A

Both acquired (Th2 and Th17 responses) and innate (epithelial cells and macrophages) immune mechanisms.

35
Q

What environmental changes help manage SPAOPD?

A

Removing horses from pasture during exacerbation periods and placing them in a low-dust environment.

36
Q

What is the effect of long-term environmental control on RAO?

A

Significant reduction in clinical signs and airway inflammation, though complete reversal may take several weeks.

37
Q

What is the clinical significance of IL-17 in RAO?

A

It is associated with neutrophil recruitment and activation, contributing to airway inflammation.

38
Q

What role do smooth muscle cells play in RAO?

A

They produce IL-8, contributing to neutrophil accumulation in the airway lumen.

39
Q

What are the main goals of RAO treatment?

A

To reduce inflammation, relieve bronchospasm, and minimize exposure to environmental antigens.

40
Q

What are the limitations of bronchodilators in RAO treatment?

A

They do not address the underlying inflammation and are primarily used for symptomatic relief.

41
Q

What is the significance of IL-8 in RAO?

A

It is a potent neutrophil chemotactic factor, contributing to the inflammation observed in RAO.

42
Q

What are common clinical signs of mild RAO?

A

Occasional cough, mild nasal discharge, and increased respiratory effort during exercise.

43
Q

What factors contribute to the chronicity of RAO?

A

Persistent exposure to environmental antigens, genetic predisposition, and sustained inflammatory responses.

44
Q

What are the potential benefits of inhaled corticosteroids in RAO?

A

Targeted anti-inflammatory effects with fewer systemic side effects compared to systemic corticosteroids.

45
Q

What diagnostic methods help differentiate RAO from other respiratory conditions?

A

Clinical history, BALF cytology, lung function tests, endoscopy, and radiographic studies.

46
Q

What are common treatments for severe RAO exacerbations?

A

Systemic corticosteroids, bronchodilators, and immediate removal from the offending environment.

47
Q

What is the importance of client education in managing RAO?

A

Educating clients on environmental control and proper management techniques to reduce antigen exposure and prevent exacerbations.

Equine Clinical Immunology (32 decks)

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