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equine clinical immunology > Chapter 26 Immunoglobulin Therapy > Flashcards

Chapter 26 Immunoglobulin Therapy Flashcards

1
Q

What is the main purpose of immunoglobulin administration in equine practice?

A

To provide passive immunity, manage infectious diseases, and offer immunomodulation for conditions like immune-mediated thrombocytopenia.

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2
Q

What are the forms of immunoglobulin products used in equine therapy?

A

Plasma, serum, or concentrated immunoglobulin proteins.

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3
Q

What conditions indicate the use of immunoglobulin therapy in horses?

A

Failure of passive transfer, prophylaxis from infectious diseases, management of infectious gastrointestinal diseases, hypoproteinemia, endotoxin neutralization, and immune-mediated thrombocytopenia.

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4
Q

What document aids equine practitioners in selecting immunoglobulin products?

A

The AAEP Biologics and Therapeutic Agents Committee’s White Paper on Equine Plasma and Serum Products.

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5
Q

Why is the use of licensed products preferred over non-licensed ones in immunoglobulin therapy?

A

Licensed products ensure safety, efficacy, and regulatory compliance, whereas non-licensed products lack regulatory oversight.

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6
Q

What should practitioners do if they are uncertain about the licensing process for immunoglobulin products?

A

Contact the USDA Center for Veterinary Biologics or visit their website for information.

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7
Q

What are the main advantages of using fresh-frozen plasma in neonatal foals with failure of passive transfer?

A

Increases circulating IgG concentration, provides bactericidal and neutralizing activities, and improves cardiovascular stability.

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8
Q

What is the target IgG concentration in neonatal foals receiving plasma for failure of passive transfer?

A

Above 800 mg/dL, ideally above 1000 mg/dL.

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9
Q

What are the primary pathogens against which immunoglobulins provide protection in foals with failure of passive transfer?

A

Gram-negative bacteria.

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10
Q

What is the standard dose of fresh-frozen plasma for a foal with partial failure of passive transfer?

A

20 mL/kg, approximately 1 L of plasma per 50 kg foal.

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11
Q

What are the potential adverse reactions during plasma transfusion in foals?

A

Elevated respiratory rate or effort, tachycardia, pyrexia, and hypersensitivity reactions.

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12
Q

When should circulating IgG concentration be re-evaluated after plasma transfusion in foals?

A

Approximately 2–4 hours following the transfusion.

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13
Q

What conditions might necessitate repeat plasma transfusions in foals?

A

Ongoing sepsis and pathogen challenge.

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14
Q

What is the purpose of administering immunoglobulins to septic equine patients?

A

To neutralize circulating endotoxin and manage systemic inflammatory response.

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15
Q

What are the key components of endotoxin in Gram-negative bacteria?

A

Lipopolysaccharide (LPS).

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16
Q

What are the clinical signs of endotoxemia in horses?

A

Altered core body temperature, tachycardia, injected mucous membranes, prolonged capillary refill time, and intestinal hypomotility.

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17
Q

What severe complications can arise from endotoxemia in horses?

A

Disseminated intravascular coagulation, vascular thrombosis, and laminitis.

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18
Q

What types of plasma products are preferred for endotoxemic patients?

A

Products originating from horses hyperimmunized against Salmonella and E. coli.

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19
Q

What additional proteins in fresh-frozen plasma benefit septic equine patients?

A

Albumin, protein C, fibronectin, and antithrombin.

20
Q

Why is fibronectin important in managing septic equine patients?

A

It aids in the clearance of immune complexes, damaged platelets, and particulate matter, stabilizes blood clot organization, and facilitates wound healing.

21
Q

What is the significance of antithrombin in treating septic horses?

A

Provides anticoagulant and anti-inflammatory properties, and its restoration is crucial for managing coagulation disorders.

22
Q

What is a potential risk of combining heparin with antithrombin in plasma transfusion?

A

Heparin may attenuate the anti-inflammatory effects of antithrombin.

23
Q

What is the recommended treatment for hypoproteinemic equine patients?

A

Human albumin has been reported as a safe and efficacious colloidal therapy, though large-scale clinical trials are lacking.

24
Q

What adverse reactions can occur with the use of human albumin in equine patients?

A

Facial swelling and delayed-type hypersensitivity reactions.

25
Q

What is the primary aim of administering hyperimmune plasma against Rhodococcus equi in foals?

A

To prevent R. equi-associated pneumonia on endemic farms.

26
Q

What are important considerations for administering hyperimmune plasma for Rhodococcus equi prophylaxis?

A

Administer at least 1 L of licensed hyperimmune plasma no later than the second day of life, with a possible additional liter at 14–32 days of age.

27
Q

What is the role of intravenous immunoglobulin (IVIg) therapy in treating immune-mediated thrombocytopenia (IMT) in horses?

A

Dilutes and removes antibodies targeted against platelet surface proteins, providing therapeutic benefit.

28
Q

What is the recommended dose of plasma for treating IMT in horses?

A

20 ml/kg/day for 2–5 days.

29
Q

What are the multifaceted mechanisms of treatment success with high-dose plasma transfusion for IMT?

A

Blocked Fc receptor binding, steric hindrance of immune complex adherence, enhanced T-lymphocyte suppressor activity, and reduced B-lymphocyte function.

30
Q

What is the main immunologic benefit of immunoglobulin therapy in horses with hypoproteinemia?

A

Provides essential proteins, increases oncotic pressure, and improves cardiovascular stability.

31
Q

What are the potential risks associated with the administration of immunoglobulin therapy?

A

Immediate or delayed hypersensitivity reactions, hypocalcemia, intravascular volume overexpansion, and hepatic necrosis.

32
Q

Why is close patient monitoring imperative during immunoglobulin therapy?

A

To detect and manage potential adverse hypersensitivity reactions.

33
Q

What is the significance of using licensed immunoglobulin products?

A

Ensures the product is harvested from healthy donors free from infectious diseases, and adheres to regulatory standards for safety and efficacy.

34
Q

What are the clinical signs of a hypersensitivity reaction to plasma transfusion?

A

Elevated respiratory rate or effort, tachycardia, pyrexia, and anaphylaxis.

35
Q

What is the effect of ongoing sepsis on the half-life of circulating antibody proteins from plasma transfusion?

A

Results in enhanced catabolism and an abbreviated half-life of circulating antibody proteins.

36
Q

What is the purpose of hyperimmunizing donor horses for plasma products?

A

To ensure high levels of specific antibodies against targeted pathogens, providing effective prophylaxis and treatment.

37
Q

What is the role of antithrombin in managing coagulopathies in septic horses?

A

Restores depleted antithrombin levels, providing anticoagulant and anti-inflammatory effects.

38
Q

What are the benefits of fresh-frozen plasma in managing endotoxemia?

A

Neutralizes endotoxins, provides essential proteins, and improves coagulation and inflammatory profiles.

39
Q

What are the potential benefits of using immunoglobulin therapy in equine patients with severe gastrointestinal diseases?

A

Regulates altered coagulation profiles, balances inflammatory pathways, and improves overall patient stability.

40
Q

What is the impact of fibronectin on the immune response in septic equine patients?

A

Facilitates the clearance of immune complexes and stabilizes blood clot organization, aiding in the resolution of systemic inflammation.

41
Q

What is the recommended dose of fresh-frozen plasma for foals with complete failure of passive transfer?

A

Up to 2 L to achieve adequate IgG levels.

42
Q

What are the clinical indications for using hyperimmune plasma against Streptococcus equi in horses?

A

Treatment of Streptococcus equi infections, including Strangles.

43
Q

What is the role of endotoxin-neutralizing immunoglobulins in managing Gram-negative sepsis?

A

Reduces the expression and signaling of inflammatory mediators, improving clinical outcomes.

44
Q

What is the therapeutic effect of immunoglobulin therapy in immune-mediated thrombocytopenia?

A

Dilution and removal of antibodies targeted against platelet surface proteins, enhancing platelet survival.

45
Q

What is the potential adverse reaction of hepatic necrosis associated with plasma therapy called?

A

Theiler’s disease.

46
Q

What are the clinical outcomes of using human albumin as a colloidal therapy in equine patients?

A

Safe and efficacious, though adverse events like hypersensitivity reactions may occur.

47
Q

What is the importance of administering immunoglobulin therapy prior to pathogen challenge in foals?

A

Provides protection against infections, reducing morbidity and mortality during the perinatal period.

equine clinical immunology (32 decks)

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