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Sarah - Mulller and Kirk > Chapter 8 - hypersensitivity > Flashcards

Chapter 8 - hypersensitivity Flashcards

1
Q

Urticaria occurs with which types of hypersensitivity reaction?

A

I and III

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2
Q

How long does an individual urticarial lesion last?

A

24 hours

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3
Q

How do you differentiate urticarial papules from bacterial folliculitis?

A

Urticaria blanches on diascopy

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4
Q

Name three drugs known to cause urticaria/angioedema

A

Penicillins, cefalexin, tetracycline, vitamin K, amitraz, ivermectin, moxidectin, radiocontrast agents, vincristine, azathioprine, propylthiouracil

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5
Q

Which cytokines are involved in acute urticaria?

A

IL-4, IL-13

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6
Q

Which cytokines are involved in chronic urticaria?

A

IL-2, IL-12, IFN-gamma

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7
Q

In atopic skin, is the number of Langerhan’s cells increased or decreaed?

A

Increased

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8
Q

In atopic skin, is the CD4:CD8 ratio increased or decreaed?

A

Increased

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9
Q

Which route of allergen exposure is most important in dogs?

A

epicutaneous

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10
Q

Which two anatomical sites have the highest frequency of isolation of Malassezia?

A

Interdigital skin and ears

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11
Q

Epithelial cells present superantigens to which type of T cells?

A

Th2

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12
Q

Which anatomical sites show lesions in both atopic dermatitis and contact dermatitis?

A

Hairless, ventral areas e.g. axillae, groin, interdigital skin

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13
Q

Name five reasons for false negative IDT

A

Too little allergen (out of date, too dilute, low volume)
Drugs (steroids, antihistamines, tranquilisers, progestatinal compounds)
Low blood pressure
Testing out of peak season
Oestrus, false pregancy
Severe stress
Parasites

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14
Q

Name five reasons for false positive IDT

A 
Irritant allergens
Contamination (bacteria, fungi)
Skin-sensitising antibodies
Poor technique
Narcotics
Irritable skin
Dermatographism
Mitogenic allergen
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15
Q

Can histamine reactivity on IDT return before allergen reactivity after drug therapy?

A

Yes - rarely

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16
Q

Which breeds may be predisposed to severe adverse reactions to IDT?

A

Boxers and Pitbulls

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17
Q

How long are allergen-specific IgE levels stable for?

A

~ 2 months

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18
Q

Is spongiotic dermatitis with eosinophilic exocytosis reported in acute or chornic atopic dermatitis?

A

Acute

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19
Q

How does ASIT change the Th2 and Th1 response?

A

It modulates the cytokine profile with an increased IFN-gamma:IL-4 ratio

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20
Q

Which cytokines, produced by Treg cells, induce a tolerance response?

A

IL-10, TGF-beta

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21
Q

Put the following in order of cross reactivity:

weeds, trees, grasses

A

Trees > weeds > grasses

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22
Q

Which cytokines does ciclosporin suppress?

A

IL-2, IL-1, IL-6, TNF-alpha

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23
Q

Giving ciclosporin with food decreases bio-availability by what %?

A

22%

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24
Q

In cats with atopic dermatitis, which T cells are increased in lesional skin?

A

CD4+ (4x more often than CD8+)

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25
Q

Facial and neck pruritus in feline atopic dermatitis may be linked to the distribution of which inflammatory cell in the skin?

A

Mast cells (found in highest numbers on caudal pinnae and chin)

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26
Q

Which primary skin lesions do you see with contact hypersensitivity?

A

Macular papular erythema

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27
Q

Which type of hypersensitivity reaction is contact?

A

IV

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28
Q

Which cells play an important role in hapten sensitisation?

A

Epidermal Langerhan’s cells

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29
Q

T memory cells are recruited by the expression of which adhesion molecules in contact hypersensitivity?

A

VCAM-1, E-selectin, ICAM-1 (on vascular endothelium)

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30
Q

Which otic preparation ingredient is frequently suspected to cause a contact reaction?

A

Propylene glycol

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31
Q

What is the rationale for using pentoxifylline to treat contact allergy?

A

Inhibition of TNF-alpha release

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32
Q

Flea bite hypersensitivity is assciated with which Th response?

A

Th2

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33
Q

Name two flea treatments that work by potentiating GABA

A

Spinosad, selamectin, milbemycin, moxidectin

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34
Q

Name an acetylcholine nicotinic receptor agonist flea treatment

A

Imidacloprid, nitenpyram

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35
Q

Which type of hypersensitivity reactions occur with tick bites?

A

III, IV and basophil

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36
Q

Type III hypersensitivity reactions to tick bites show what type of pattern on histopathology?

A

Leukocytoclastic vasculititis with haemorrhage, necrosis and ulceration

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37
Q

Type IV hypersensitivity reactions to tick bites show what type of pattern on histopathology?

A

Nodular to diffuse (pyo)granulomatous dermatitis

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38
Q

What type of hypersensitivity reaction occurs with feline mosquito hypersensitivity?

A

Type I

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39
Q

Which inflammatory cell predominates on histopathology of fire ant stings?

A

Neutrophils

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40
Q

Which species of storage mite is predominant in Europe?

A

Lepidoglyphus destructor

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41
Q

Name two differentials for canine eosinophilic furunculosis

A

Staphylococcus folliculitis/furunculosis and dermatophytosis

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42
Q

Which sex hormone most commonly triggers hypersensivitity?

A

Progesterone

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43
Q

Which receptors involved in pathogen detection are expressed by keratinocytes?

A

Toll-like receptors (TLRs)

Protease-activated receptors (PARs)

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44
Q

Acute lesions in atopic dermatitis are associated with which Th cells?
Th1
Th2

A

Th2

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45
Q

Keratinocyte expression of thymic stromal lymphopoietin (TSLP) in atopic dermatitis is:
Increased
Decreased

A

Increased and this correlated with dry skin/stratum corneum hydration

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46
Q

TSLP-stimulated dendritic cells prime CD4 T cells with features of Th1 or Th2 cells?

A

Th2

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47
Q

Dysbiosis has been reported in atopic dogs, what changes have been found?

A

Decreased bacterial diversity and increased proportions of Staphylococcus, particularly S. pseudintermedius and Corynebacterium spp. compared with healthy control dogs

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48
Q

In a pilot study evaluating five different methodologies (skin hydration, TEWL, pH, skin absorbance and erythema) for skin barrier function assessment done in both normal and atopic dogs, which was the most repeatable?

A

pH

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49
Q

Which tight junction proteins have been investigated in dogs with AD?

A

Claudin, occludin and Zonula Occludens 1 (ZO-1)

Decreased claudin 1 expression has been reported in samples from atopic dog skin (non-lesional skin)

Decreased intensity of staining for ZO-1 on immunohistochemical analysis also has been reported in atopic dogs

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50
Q

A cell wall component of Staphylococcus can induce transcription of _____ via TLR2 in canine keratinocytes and this could be a link to explain Th2 responses precipitated by Staphylococcus.

A

TSLP

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51
Q

True or false:

Treg cells are significantly increased in atopic dogs compared to normal and correlate with disease severity

A

True

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52
Q

In the study by Older et al (2021) looking at cats with asthma and FASS, they found significantly higher mRNA expression of Oncostatin M receptor (OSMR)-beta in samples obtained from allergic animals. What is OSMR-beta?

A

OSMR-beta is one of the subunits of the heterodimeric receptor complex for IL-31. Upon binding of IL-31, the IL-31 receptor complex induces signalling via the JAK/STAT/PI3K/AKT and several other pathways

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53
Q

In the study by Older et al (2021) looking at cats with asthma and FASS, did they find a significant role for IL-31?

A

No, neither the qPCR nor the RNA-ISH results demonstrated differences in systemic or cutaneous IL-31 expression between cats with allergic dermatitis and controls; this does not rule out that targeting molecules within the IL-31 pathway may still be valuable.

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54
Q

In the study by Combarros et al (2021), what was the difference between normal, non-lesional and lesional atopic skin on electron microscopy?

A

There was an abnormal appearance of the SC and corneocytes in both lesional and non-lesional skin of atopic dogs, as well as altered morphology of purified CEs. The SC presented irregular, wrinkled and thicker corneocytes, associated with a larger proportion of ruffled, immature CEs and increased TEWL, suggesting impaired cornification.

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55
Q

In the study by Pressanti et al (2021), which cytokine was found to be over-expressed in conjunctivae and tears of atopic dogs despite subtle signs of conjunctivitis?

A

IL-8

IL-8 is primarily a chemoattractant for neutrophils

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56
Q

Oclacitinib maleate mitigates the clinical effects of cAD through its action on the signalling pathways of Janus kinase 1 (JAK1) enzymes, which modify production of several interleukins (IL) such as?

A

IL-2 and IL-6 (pro-inflammatory)
IL-4 and IL-13 (pro-allergenic)
IL-31(pruritogenic)

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57
Q

True or false, increased numbers of CD4+T cells and an elevated CD4+/CD8+T-cell ratio were shown to be hallmarks of cAD.

A

True

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58
Q

What are Favrot’s criteria?

A 
Onset of signs under 3 years of age
Dog living mostly indoors
Glucocorticoid-responsive pruritus
Pruritus without lesions at onset
Affected front feet
Affected ear pinnae
Non-affected ear margins (Sarcoptes)
Non-affected dorso-lumbar area (FBH)
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59
Q

mRNA for inflammatory and immunology markers is up or down regulated in lesional atopic skin?

A

Up-regulated

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60
Q

mRNA from genes involved in transcription and regulation is up or down regulated in non-lesional atopic skin?

A

Down-regulated

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61
Q

S100A8 gene is a pro-inflammatory marker that correlates with what?

A

Severity of canine AD and TNF-alpha

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62
Q

Thymic stromal lymphopoetin (TSLP) is induced by epidermal damage and involved in which type of Th response?

A

Th2

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63
Q

Which environmental factors appear to be protective from canine AD?

A

Rural lifestyle, multi-animal household, non-commercial foods, skin barrier protective diet

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64
Q

Which environmental factors may be associated with developing CAD?

A

Urban lifestyle, late homing, regular bathing, c-section, household hygiene and HDM exposure

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65
Q

In the study (Hemida et al, 2020) on the modifiable early risk factors for AD development in dogs, which types of diet affected the development of cAD?

A

Diets based on non-processed meat were significantly associated with a decreased prevalence of owner-reported AD, while a diet based on ultra-processed carbohydrate-rich foods were significantly associated with an increased risk for owner-reported AD

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66
Q

Which Dermatophagoides farinae major allergen has been confirmed to be clinically relevant through response to monoallergen immunotherapy?

A

Der f2

ASIT response in HDM sensitised dogs and cats

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67
Q

D. farinae IgE can cross react with which endoparasite?

A

Toxocara canis

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68
Q

Do dogs with sarcoptes show positive IgE levels to D. farinae?

A

No, but dogs with D. farinae IgE can show positive reactions to sarcoptes

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69
Q

What are the skin barrier defects reported in dogs with AD?

A
  1. Abnormal keratinocyte morphology
  2. Abnormal filaggrin expression
  3. Altered lipid lamellae
  4. Altered lipid metabolism
  5. Abnormal ceramide profiles
  6. Increased TEWL
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70
Q

In cAD, keratinocytes can initiate and activate the release of which inflammatory markers?

A 
ICAM-1
MHC II
TARC
TNF-alpha
IL-8
TSLP
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71
Q

Esumi et al. (2021) found that emollient bathing had what effect on Malassezia, pruritus and skin lesions in dogs?

A

Decreased

Skin barrier modulation can impact Malassezia dysbiosis

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72
Q

In cAD there is early activation of which Th pathways?

A

Th2 and Th22

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73
Q

Is IL-31 expressed in the early or late phase of atopic inflammation?

A

Early

Peak 24-48 hours

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74
Q

TSLP is mostly produced by keratinocytes and has what effects?

A
  1. Activates Langerhans cells and T cells, induces maturation and activation of dendritic cells and mast cells
  2. Promotes Th2 differentiation
  3. IL-4 and IL-13 production

SNP in TSLP receptor has been associated with canine AD in various breeds

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75
Q

Is there a clear association with AD and altered levels of IL-10 and TGF-beta in dogs as there is in people?

A

No, some studies have found similar levels in healthy and atopic dogs

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76
Q

Could the number of Treg cells in early life influence the development of cAD?

A

In Swiss WHWT, lower levels of Treg at 3-12 months were associated with AD later in life

Treg numbers declined in adulthood in healthy dogs but didn’t in atopic dogs

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77
Q

Apart from IL-31, what are the itch pathways/mediators in dogs?

A 
Histamine
PAR2
TRPM8 - menthol
TRPV1 - capsaicin
Cannabinoid receptors
Opioid receptors
Substance P - NK1 and GABA
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78
Q

Give examples of Th1 cytokines

A

IL-2 and interferon-gamma

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79
Q

Give examples of Th2 cytokines

A

IL-4, IL-5, IL-6, IL-9, IL-10 and IL-13

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80
Q

CCR4 is the receptor for which T-cell chemotactic factor?

A 
TARC (thymus and activation regulated chemokine)
CCL 17 (chemokine (C-C motif) ligand 17)
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81
Q

Circulating CCR4+ T cells are present in greater number in spontaneously allergic dogs compared to healthy non-allergic dogs, is the same true for experimentally sensitised dogs?

A

Yes

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82
Q

Has expression of CCR4 mRNA been demonstrated in atopic canine skin?

A

Yes

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83
Q

IFN-gamma RNA transcripts have been detected in skin biopsies of dogs with spontaneous AD, most frequently from which type of skin lesions?

A

Chronic, lichenified lesional skin

Levels in canine lesional atopic skin are higher than in non-lesional or healthy skin

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84
Q

S1008A, a calcium binding protein, is a pro-inflammatory protein that can induce chemotaxis of which cells in dogs?

A

Neutrophils

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85
Q

The S100 gene is also located on the epidermal differentiation complex with genes that are essential for which aspects of keratinocyte and epidermal barrier differentiation?

A

Profilaggrin, loricrin and involucrin

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86
Q

Do serum levels of S1008A correlate with CADESI scores in atopic dogs?

A

Yes and increased gene expression was demonstrated in lesional atopic skin.

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87
Q

IgE has been demonstrated to be expressed on the surface of Langerhans cells in the epidermis of atopic dogs; has the same been found in non-atopic dogs?

A

No

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88
Q

In food induced atopic dermatitis in dogs, clinical signs are present at under 12 months of age in what % of cases?

A

~50%

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89
Q

In food induced atopic dermatitis in dogs, Malassezia dermatitis is associated in what % of dogs?

A

43%

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90
Q

A dysregulated immune response in cAD includes increased Th2, Th17 and which cells expressing CD4+ and CD25+?

A

Treg - significantly increased in atopic dogs compared to normal and correlate with disease severity

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91
Q

What is oral allergy syndrome and has it been reported in dogs?

A

Oral or perioral pruritus and inflammation may be observed following ingestion of a food item that cross-reacts with an aeroallergen to which the patient is sensitised.

Reported after ingestion of tomato in a dog sensitized to Japanese cedar extract.

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92
Q

Is there evidence to suggest that Fel d1 may represent an autoallergen in cats with EGC?

A

Yes – as in humans with AD that may eventually develop IgE reactive to self-proteins and these autoallergen–antibody interactions may perpetuate allergic disease

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93
Q

Do human keratinocytes from atopic patients have higher expression of the receptor for IL-31 when compared to healthy controls?

A

Yes - they are very sensitive to this cytokine

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94
Q

IL-34 is thought to be largely produced by which cells?

A

Keratinocytes

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95
Q

Is IL-34 important in dogs?

A
  • Increased expression of IL-34 in serum in atopic dogs compared to healthy controls
  • Correlated with disease severity but did not decrease with treatment
  • Possibly produced by damaged keratinocytes – no evaluation of skin expression yet
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96
Q

Increased expression of IL-33 can have negative consequences on the function of which intercellular structures?

A

Tight junction proteins such as claudin – inflammatory cytokines can modulate skin barrier function and exacerbate existing deficiencies

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97
Q

In the study by Piccione and DeBoer (2019), were anti-CCD IgE found in healthy and atopic dogs?

A

Yes, 16.8% (17/101) atopic dogs and 13.1% (8/61) healthy dogs

All healthy and atopic dogs with anti-CCD IgE had strong reactivity to grass pollens.

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98
Q

Keratinocytes express the receptor for IL-31 and this cytokine can greatly suppress differentiation markers such as?

A

Filaggrin and cornified cell envelope formation

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99
Q

Which aspects of the canine microbiome are reduced in atopic dermatitis?

A

Decreased diversity, richness and evenness

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100
Q

Apart from atopic dermatitis, which other factors can affect the canine cutaneous microbiome?

A

Household > sex, health, body site

Breed variations

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101
Q

Has gut dysbiosis been associated with cAD?

A

Yes, as in people

A nutraceutical/low allergen diet improved gut dysbiosis, faecal scores, pruritus and lesional scores

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102
Q

What are complex carbohydrate determinants (CCDs)?

A

Carbohydrate components of glycoproteins commonly found on the cell surface of plants or insects

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103
Q

What is the average age of onset of FASS in cats?

A

2 - 3.4 years
(Ravens 2014, Hobi 2011)
WAVD 0.5-4.8 years

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104
Q

Which feline breeds are predisposed to FASS?

A

Abyssinian

Also Siamese, Persian, Devon Rex, Himalayan, Maine coon

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105
Q

Which inflammatory cells predominate in allergic and non-allergic asthma?

A

Allergic: eosinophils (neutrophils, lymphocytes, macrophages and mast cells)
Non-allergic: neutrophils

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106
Q

CD__ / IL-__ positive cells are more prominent in lesional skin in FASS than non-lesional or healthy skin

A

CD4 / IL-4

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107
Q

In cats with FASS, do serum IL-5 levels correlate with peripheral eosinophilia, allergen specific IgE or skin lesions?

A

No, no consistent correlation found

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108
Q

What is a reason why we see complex, heterogenous cytokine expression patterns in cats with FASS?

A

They can present with lesions of varying stages rather than show a more linear progression from acute to chronic

They have a variety of clinical presentations e.g. EGC

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109
Q

Which chemokines have been associated with FASS?

A

TARC / CCL17 (Th2)

RANTES / CCL5 (attract and activate T cells, eosinophils and basophils)

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110
Q

Do cats with FASS show a pro-inflammatory Th1/Th2 response?

A

Yes

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111
Q

Why do diester steroids have a low risk of systemic adverse effects when used topically?

A
  • Double esterification enhances rapid penetration of the drug through the stratum corneum and ensures specific metabolism in the deep dermis.
  • This minimizes effects on hair follicles, dermal fibroblasts and blood vessels, decreasing the likelihood of local cutaneous and systemic adverse effects
  • Can still cause dermal atrophy!
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112
Q

HCA spray (Cortavance) has been shown to be effective in dogs in which scenarios?

A
  • SID use for up to 14 days for acute AD and 7 days for FAD
  • Used two consecutive days a week to help reduce time to relapse and need for systemic medication
  • Used SID for 7 days then EOD when tapering oclacitinib from BID to SID (prevented relapse of pruritus and clinical lesions)
  • Equally as effective as ciclosporin when used daily for at least 28 days then tapered to EOD or BIW depending on response
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113
Q

In a study of 10 cats, what treatment regime was used for topical application of HCA (from FASS treatment guidelines)?

A
  • Two sprays from 10 cm to cover a 10 x 10 cm area
  • Once daily for 28 days then every other day
  • Two were lost to follow up, one was withdrawn due to poor efficacy
  • 77% reduction in FeDESI and 76% reduction in pruritus by day 56
  • 50% improvement seen by day 14
  • 6/7 cats maintained on EOD treatment, 1/7 on SID
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114
Q

Where are GC receptors found and which is the main effector of GC functions?

A

Glucocorticoid receptors (GCR) are found in all tissues, with the isoform GCR-α being the most widely expressed and the main effector of GC functions. It is cytoplasmic.

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115
Q

What does GC receptor-beta do?

A

Glucocorticoid receptor-β does not bind GC, but it can modulate steroid response by its interactions with DNA of GC responsive genes, a mechanism possibly contributing to resistance to treatment.

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116
Q

What does binding of GC to GC receptor-alpha do?

A

It causes the release of chaperone molecules and subsequent translocation of the GC-GCR complex to the nucleus. There, the interactions with GC responsive elements lead to transactivation (increase in gene expression) of anti-inflammatory genes, such as interleukin (IL)-10, or transrepression (decrease in gene expression) of pro-inflammatory genes.

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117
Q

Glucocorticoids also suppress humoral immunity, causing B cells to express lower amounts of IL-__ and IL-__ receptors

A

IL-2 and IL-2 receptors

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118
Q

Glucocorticoids induce lipocortin-1 (annexin-1) synthesis, which then binds to cell membranes preventing __________ from coming into contact with its substrate arachidonic acid.

A

Phospholipase A2

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119
Q

Which two main products in inflammation are reduced by GCs?

A

Prostaglandins and leukotrienes (any of a group of biologically active compounds, originally isolated from leucocytes. They are metabolites of arachidonic acid)

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120
Q

Topical steroids can cause cutaneous atrophy, which other adverse effects have been reported with their use?

A
  • Localised demodicosis reported in cats and dogs using steroid inhalers
  • Iatrogenic hypercortisolism reported with clobestasol lotion in Persian kitten
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121
Q

In the study by Leonard et al. (2021), did the use of twice weekly otic mometasone furoate affect the skin microbiome?

A

No - topical corticosteroids used as proactive treatment is unlikely to increase the risk of secondary microbial overgrowth

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122
Q

Are adverse effects associated with genomic or non-genomic actions of steroids?

A

Typically associated with genomic actions of GCs

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123
Q

Non-genomic affects are responsible for rapid onset of action (<30 mins) and various mechanisms are involved such as…

A

Both inflammatory pathways and non-inflammatory pathways such as calcium mobilization, muscle tone, and reactive oxygen species are targets for the GC non-genomic effects

124
Q

Do topical EFAs help to normalise SC lipid barrier defects seen in cAD?

A

Yes – however, the results of clinical trials are inconsistent and they are unlikely to be beneficial to dogs on EFA supplements or EFA enriched diets

125
Q

According to ICADA guidelines, when should topical tacrolimus be considered instead of topical steroids?

A

When skin atrophy is visible

126
Q

Can emollient shampoos (+/- foams) reduce skin lesions and pruritus in cAD? E.g.:
Allermyl (Virbac) - lipids, complex sugars and antiseptics
Douxo Calm (Ceva) - phytosphingosine, raspberry oil and lipids

A

They can provide a modest effect on skin lesions and pruritus in allergic dogs - this benefit is likely highest in dogs with mild AD and the intensity and frequency of bathing may be the most important factor

127
Q

In the review by Tresch et al. (2019), which four plants were found to have antimicrobial and / or wound healing properties?

A
  • Calendula officinalis (Marigold) - antimicrobial
  • Hypericum perforatum (St. John’s Wort) – antimicrobial and wound healing
  • Matricaria chamomilla (syn. Matricaria recutita L., Chamomile) – antimicrobial and wound healing
  • Salvia officinalis (Sage) – antimicrobial
128
Q

In the study by Marsella et al. (2017), did a blackcurrant emulsion enriched in essential fatty acids, ceramides and 18-betaglycyrrhetinic acid improve clinical signs in dogs with AD?

A

NO - There was a transient reduction in pruritus after one month but no significant difference between the treatment and placebo at two and three months and no differences at any stage in CADESI, TEWL and global assessment

129
Q

Did Besignor and Fabries (2018) find an improvement in CADLI and pVAS in 8 dogs treated with Douxo calm or ATOP 7 foams?

A

Yes, reduction in both CADLI and pVAS – no significant difference between products (blinded, randomised, cross-over trial, 14-day washout).

Reductions were <50% when used alone in mild to moderate cases of cAD

130
Q

True or false? Cannabinoid receptor agonists can be anti-inflammatory and anti-pruritic.

A

True

131
Q

In the study by Marsella et al. (2019), did a topical endocannabinoid membrane transporter inhibitor (WOL067-531) reduce pruritus and dermatitis scores in HDM sensitive dogs when epicutaneously challenged?

A

Yes – significant difference in pruritus and dermatitis scores compared to the vehicle group

132
Q

Can topical therapy using ATOP 7 help extend the time to flare in atopic dogs treated with Cytopoint?

ATOP 7 (hemp seed oil rich in omega 3and omega 6 essential fatty acids, pyrrolidone carboxylic acid and glycerine)

A

Yes – topical therapy was associated with a longer lasting remission (Besignor and Videmont (2022))

133
Q

Marsella et al. (2004); 0.1% tacrolimus ointment compared to placebo (vehicle) applied once daily for four weeks for cAD. Did it reduce severity of owner perceived clinical signs and CADESI?

A

Yes for both, significantly decreased from day 0 to 28 (end of trial) - placebo did not

134
Q

Marsella et al. (2004); 0.1% tacrolimus ointment compared to placebo (vehicle) applied once daily for four weeks for cAD. Was there evidence of systemic absorption?

A

Yes, tacrolimus was detected in the blood but it was below the level of toxicity

135
Q

Besignor and Olivry (2005); 0.1% tacrolimus ointment compared to placebo (Vaseline) applied twice daily for six weeks for cAD. What % improvement was seen and what % improved by 50% or more?

A

Median of 63% improvement and 75% had lesion improvement of 50% or more

136
Q

Tacrolimus inhibits T-cell response by forming a complex with what?

A

A cyclophilin-like protein (FKBP12) which inhibits the ability of calcineurin to dephosphorylate the transcription factor required for the activation of IL-2 and IL-4 gene transcription

137
Q

Tacrolimus inhibits the expression of IL-2R (CD25) and which co-stimulatory molecules?

A

CD80 (B7.1) and CD40, and both classes of major histocompatibility complex (MHC)

138
Q

Which type of genome study uses a family based approach?

A

Genome-wide linkage studies

139
Q

Which type of genome study identifies single nucleotide polymorphisms (SNPs) that are more frequent in affected individuals compared to controls?

A

Genome-wide association studies

140
Q

Which candidate gene for cAD codes for a transport protein found on lipid anchors?

A

RAB3C

141
Q

Which candidate gene for cAD is found on chromosome 17, encodes a lymphoid tyrosine phosphatase involved in the prevention of spontaneous activation of T and B cells?

A

PTPN22

142
Q

Which candidate gene for cAD near chromosome 17, is involved in adipogenesis and retinoic acid pathways?

A

Canine orthologue of the cytochrome P450 26B1 gene

143
Q

A SNP related to what protein associated with cAD, has been found in candidate gene studies for all breeds it has been tested for (8 breeds)?

A

Thymic stromal lymphopoetin receptor

144
Q

In the study of British guide dogs, what was the heritability of cAD?

A

0.47

Nearly 50% of the risk of developing AD was determined by an individual’s genotype

145
Q

In a study of WHWT in Switzerland, what was the heritability of cAD?

A

The direct heritability was 0.31 with a highest posterior density interval (HPDI) ranging from 0.09 to 0.87, the maternal genetic heritability was 0.04 and the maternal permanent environmental heritability was 0.03

146
Q

Which genetic and early life environmental risk factors have been associated with cAD?

A

Mother allergic
Male sex
Breed
Born in autumn

147
Q

Which early life environmental risk factors have been reported to be protective from cAD?

A 
Home-made food during pregnancy
 Adoption < 3 months of age
 Adoption > 6 months of age
 Being born into the owner’s family
 Rural life style
148
Q

What is the composition of the intercellular lipid component in the stratum corneum? What are their percentages?

A

Ceramides 50%
Cholesterols 25%
Fatty acids 10 to 15%

149
Q

In atopic dogs, lesional skin and serum show decreased concentrations of (a lipid) ____________, possibly secondary to enhanced metabolism.

A

Sphingosine-1 phosphate

It is formed from ceramide, which is composed of a sphingosine and a fatty acid.

150
Q

How does reduced levels of Sphingosine-1 phosphate influence the development of cAD?

A

It might permit increased transport of activated antigen-bearing DCs into the draining lymph nodes, facilitating the development of sensitization

151
Q

True or false?
Large amounts of glucosylceramides have been found among the free lipids in the stratum corneum of dogs with AD, although they are nearly absent from the stratum corneum of healthy dogs.

A

True

152
Q

At which body site is TEWL positively correlated with CADESI score?

A

Ear pinnae

153
Q

In which breed has an association between a single nucleotide polymorphism in the flg gene and CAD been demonstrated?

A

Labrador retrievers in UK

154
Q

What is the effect of anti-inflammatory treatment and skin barrier care on the microbiome of atopic dogs?

A

There is an increase in the diversity of bacterial flora

155
Q

Although the same bacterial taxa are present in cAD and healthy dogs, the relative abundance of taxa varies between the two groups. Which species is significantly relatively abundant in atopic dogs during flares?

A

Staphylococcus species

156
Q

Concurrent with cAD flares, alpha diversity _______ and is correlated with disease severity, TEWL, and pH (Bradley et al., 2016)

A

Decreases

157
Q

Based on the results of recent research (Rodriguez-Campos et al.,2020) on WHWTs, did individual early-life microbiota predispose for the later development of cAD?

A

No

158
Q

What % of dogs showed resolution of clinical signs after 5 and 8 weeks of an elimination diet trial?

A

85% at 5 weeks

95% at 8 weeks

159
Q

What % of cats showed resolution of clinical signs after 4, 6 and 8 weeks of an elimination diet trial?

A

50% at 4 weeks
80% and 6 weeks
90% and 8 weeks

160
Q

Which are the most common food allergens in dog?

A 
Beef (34 %)
Dairy products (17 %)
Chicken (15 %)
Wheat (13 %)
Lamb (14, 5 %)
161
Q

Which are the most common food allergens in cat?

A

Beef (18 %)
Fish (17 %)
Chicken (5 %)

162
Q

Which other plant-based food allergens have been reported in dogs and cats?

A 
Soy (D)
Corn (D,C)
Rice (D)
Barley (D,C)
Kidney beans (D)
Tomato (D)
Wheat (C)
163
Q

What % of dogs presented to a vet for any diagnosis had CAFR?

A

1-2%

164
Q

What % of dogs presented to a vet for skin disease had CAFR?

A

6%

165
Q

What % of dogs presented to a vet for pruritus had CAFR?

A

18%

166
Q

What % of dogs presented to a vet for allergic skin disease had CAFR?

A

29%

167
Q

What is the prevalence of CAFR in cats?

A

0.2%

168
Q

What % of cats with skin disease have CAFR?

A

5%

169
Q

What % of cats with pruritus have CAFR?

A

12-21%

170
Q

What % of cats with allergic skin disease have CAFR?

A

10%

171
Q

Which test can be useful in choosing the ingredients for an elimination diet and in which species?

A

Patch testing

Dogs

172
Q

Which laboratory tests have the highest accuracy in diagnosis of CAFR?

A

Lymphocyte proliferation tests
Accuracy in dogs 94%, cats 80%

It is technically difficult to conduct these tests and blood specimens need to be processed very quickly after sampling

173
Q

Which is the commonest method to detect possible contamination of a food with another protein-source?

A

PCR (less common ELISA, mass spectrometry)

174
Q

In studies testing pet foods with “novel/limited” ingredients proposed for elimination diets, the percentage of mislabeling varied from ___ to ___ of evaluated foods.

A

33 to 83%

175
Q

The pet foods with hydrolyzed proteins were also found to contain protein sources from an unexpected species. True or false?

A

True

176
Q

Vomiting and diarrhoea are reported in what % of dogs and cats with AFR?

A

20%

177
Q

Which neurological condition of Border terriers is associated with an AFR?

A

Paroxysmal gluten-sensitive dyskinesia of Border terriers

178
Q

What are the non-cutaneous signs of AFR in dogs?

A

Anaphylaxis, conjunctivitis, increased frequency of defecation, symmetric lupoid onychitis, sneezing

179
Q

What are the non-cutaneous signs of AFR in cats?

A

Conjunctivitis (12%), salivating, flatulence, hyperactive behaviour (rare) and respiratory signs (11%)

180
Q

What % of dogs and cats develop signs of AFR before 12 months of age?

A

Dogs 38%

Cats 23%

181
Q

What are some of the less common cutaneous signs of AFR in dogs?

A

Malassezia dermatitis
Urticaria
Perianal fistulae/furunculosis

182
Q

What was the most common pruritic anatomical location in CAFR cats?

A

Head and neck (53%)

183
Q

What are the two most common clinical presentations in CAFR cats?

A

Self-induced, often-symmetric alopecia (40 to 100%)

A head-and-neck erosive/ulcerative/crusted dermatitis (30 to 65%)

184
Q

Which are the most common storage mites?

A

Acarus siro
Lepidoglyphus destructor
Glycyphagus domesticus
Tyrophagus putrescentiae

185
Q

Do storage mites cross react with HDM?

A

Yes - can lead to false positive responses to provocation with food trials (need to use home-cooked ingredients to avoid this)

186
Q

What are the optimum conditions for T. putrescentiae to proliferate in food bags?

A

Fat- and protein-rich dog food
High humidity
Crushed kibble
Mould on the kibble (higher mites’ proliferation)

187
Q

What % of dogs and cats exhibited a flare within 24 hours of dietary provocation?

A

Dogs 9%

Cats 27%

188
Q

What % of dogs and cats exhibited a flare within 48 hours of dietary provocation?

A

Dogs 21%

Cats 29%

189
Q

50% of dogs and cats show a flare in signs following what length of time of dietary provocation?

A

Dogs 5 days

Cats 4 days

190
Q

90% of dogs and cats show a flare in signs following what length of time of dietary provocation?

A

Dogs 14 days

Cats 7 days

191
Q

Do injections of Gordonia bronchialis or Rhodococcus coprophilus effectively reduce the signs and symptoms of flea allergy in dogs?

A

Yes - Both reduced the extent and severity of lesions (p < 0.001), reduced scratching and reduced circulating eosinophil counts

192
Q

In the study by Bond et al. (2006), which test was best able to identify cats with FBH?

A

Live flea challenge

193
Q

Which salivary antigen is involved in FBH?

A

Cte f 1 (AKA feline salivary antigen 1 - FSA 1)

194
Q

Do healthy cats tolerate higher concentrations of allergens than dogs do (IDT irritant threshold)?

A

Yes

195
Q

Which factors influence the levels of IgE in non-allergic cats?

A
  • IgE increases with age

- Serum IgE is higher in outdoor cats and cats with endoparasites

196
Q

Which is more heat stable, IgG or IgE?

A

IgG

197
Q

Lower respiratory disease diagnosed as probable or definitive asthma was reported concurrently with FASS in what % of cats?

A

6-7%

198
Q

How do you determine the irritant threshold concentration of allergens for IDT?

A

By evaluating the lowest concentration at which at least 10% of normal patients react

199
Q

How do you use fluorescein for IDT?

A
  1. 10% fluorescein sodium solution is administered at a dosage of 5 mg/kg i.v. immediately after test injections are completed.
  2. Test reactions are interpreted in a dark room with the aid of a Wood’s lamp and both fluorescent intensity and wheal diameter are evaluated.
200
Q

Scholz et al. (2017); What was the irritant threshold concentrations in cats for Cynodon dactylon (Bermuda grass) and Schinus spp. (peppercorn)?

A

Between 6000-8000 PNU/mL

201
Q

Scholz et al. (2017); could threshold concentrations for other pollens be determined in cats?

A

No - no reactions at 8000 PNU/mL bar Cynodon dactylon (Bermuda grass) and Schinus spp. (peppercorn)

202
Q

Are antigen presenting cells increased in allergic vs healthy cats?

A

Yes, Langerhans cells were three times higher and dermal dendritic cells two times

203
Q

Stem cell factor levels were significantly higher in the cats affected by FASS than those in the healthy control; which cells does SCF stimulate growth, migration and differentiation of?

A

Mast cells

Also induces eosinophil adhesion and activation

204
Q

A significant positive correlation (r=0.64) has been reported between the serum levels of ____ and Scoring Feline Allergic Dermatitis (SCORFAD) score

A

Flt3L (Fms-related tyrosine kinase 3 ligand) - regulates dendritic cell development and activation

205
Q

Is there evidence of skin barrier dysfunction in atopic cats?

A

No

  • TEWL may be increased however, there is limited evidence of any useful correlation between clinical scoring systems and measurements of hydration
  • No study has reported on filaggrin and lipid abnormalities in the skin of allergic cats.
206
Q

Older et al. (2021) found which Staph were most frequently found in FASS?

A

S. felis and S. capitis

They otherwise found similar microbiome profiles in FASS and healthy cats

207
Q

Feline food allergy has been associated with which atypical cutaneous manifestations?

A

Urticaria
Nonpruritic nodules
Plasma cell pododermatitis

208
Q

What are the four groups of typical manifestations of FASS?

A
  • Miliary dermatitis
  • Self-induced alopecia/hypotrichosis
  • Head and neck pruritus
  • EGC
209
Q

Eosinophilic plaques are most frequent at which body sites?

A

Ventral abdomen and medial thighs

210
Q

Which FASS reaction patterns are most common?

A
  1. 1% with self-induced alopecia/hypotrichosis
  2. 0% with head and neck pruritus
  3. 2% with miliary dermatitis
  4. 9% with one or more forms of EGC
211
Q

True or false; in contrast with dogs, paw involvement appears to be uncommonly involved in FASS

A

True

212
Q

In cats, the presence of otitis, with or without secondary infections, has been reported in ____% of patients with FASS.

A

20.9%

213
Q

In FASS are females over-represented?

A

Yes

214
Q

What % of cats with FASS demonstrate seasonal clinical signs?

A

25-30%

215
Q

In FASS, what % of cats have concurrent respiratory signs or conjunctivitis?

A

Respiratory (e.g. sneezing, asthma) 8.3%

Conjunctivitis 4.8%

216
Q

In FASS, what % of cats have concurrent food allergy?

A

Up to 13%

217
Q

What is the average age of onset of food allergy in cats?

A

Between 3.4 and 4.9 years

218
Q

Reversible spontaneous bronchoconstriction (airway ______ ______ constriction), oedema of the bronchial mucosa, excessive _____ production and chronic airway remodelling are seen in feline asthma.

A

Smooth muscle

Mucus

219
Q

What are the WAVD listed differentials for EGC?

A
  • Flea allergy dermatitis
  • Food allergy
  • Mycobacteriosis
  • Nocardiosis
  • Fungal disease (sporothricosis)
  • Viral diseases
  • Skin neoplasia (cutaneous lymphoma, mast cell tumour, squamous cell carcinoma)
  • Deep bacterial infection
  • Sterile granulomatous skin diseases (e.g. xanthomatosis)
220
Q

True or false; Staphylococcal and Malassezia overgrowth/infection is very common in allergic cats

A

True

221
Q

If at least 6/10 of the following are present, what is the sensitivity and specificity for diagnosing FASS?
Presence of pruritus at onset
Presence of at least two of the four clinical patterns:
•Symmetrical alopecia
•Miliary dermatitis
•Eosinophilic dermatitis
•Head and neck erosions/ulcerations
Presence of at least two sites affected
Presence of miliary dermatitis as a dominant pattern
Presence of eosinophilic dermatitis or symmetrical alopecia or erosions /ulcerations on the head, face, lips, ears or neck
Presence of nonsymmetrical alopecia on the rump, tail or hindlimbs
Presence of symmetrical alopecia on the abdomen
Absence of erosions/ulcerations on the forelimbs
Absence of nodules or tumours

A

Sensitivity 90%

Specificity of 83%

222
Q

If fluorescein is used for IDT, is the diameter of the positive reaction considered to be more important than the intensity?

A

Yes

223
Q

How is percutaneous prick testing performed?

A
  1. Using allergens at a dilution of 1:20 w/v (i.e. undiluted)
  2. Once the patient is sedated, the lateral thorax is clipped and the sites for the “pricks” are marked.
  3. A drop (0.05 mL) of the allergen (or control) is applied and introduced into the skin via the prick device
  4. Reactions are read at 15–20 min
224
Q

There are few studies on the frequency of IDT reactions in cats; in Australia, which were most common?

A

Pollens (grass, weed and/or tree) in 89.5%
Insects (flea, mosquito, ant, moth, horsefly and housefly) in 68.4%
HDM in 47.4%
Flea in 42%

225
Q

What is the reported efficacy of ASIT in cats?

A

45-75%

226
Q

Complete remission with ASIT has been reported in what % of cats with FASS and asthma?

A

FASS - 26%

Asthma - 67%

227
Q

What airway changes are associated with rush immunotherapy is asthmatic cats?

A
  • Decreased IL-4/IFN-gamma ratio in the bronchoalveolar lavage fluid (BALF)
  • Air-way eosinophilia decreased and the percentage of Treg and IL-10-producing cells increased
228
Q

What dose of methylprednisolone was effective as an induction dose for treating FASS?

A

1.5 mg/kg (1.9 mg/kg pred)

229
Q

Has hypothalamic–pituitary–adrenal axis suppression been documented with inhaled flunisolide and budesonide?

A

Yes, when high doses are used

230
Q

What % of cats with FASS can be maintained on twice weekly ciclosporin?

A

~60%

231
Q

Toxoplasmosis and which other infectious disease has been seen in cats receiving ciclosporin?

A

Cryptococcosis

232
Q

Why should Toxoplasma serology be performed before starting ciclosporin treatment?

A

Cats that get infected with Toxoplasma gondii while receiving ciclosporin daily develop much more severe clinical signs, or even die.
- Shedding of oocysts or recurrence of clinical signs was not seen in cats already infected with Toxoplasma before ciclosporin administration

233
Q

What dose of oclacitinb is recommended by WAVD for FASS?

A

1 mg/kg once or twice daily

Carrasco et al. (2021); BID for 14 days then SID

234
Q

Which antihistamine do WAVD recommend for FASS?

A

Chlorphenamine

235
Q

There is moderate evidence for the use of EFA in cats with miliary dermatitis and which other type of supplement for FASS?

A

Ultramicronised palmitoylethanolamide (PEAum)

236
Q

Maropitant at 2 mg/kg orally SID for 28 days, reduced pruritus and SCORFAD by > 50% in what % of cats?

A

> 50% SCORFAD 83%

> 50% Pruritus 92%

237
Q

What effect did systemic amoxyclav have on eosinophilic plaques and indolent ulcers in cats? All had cytological evidence of neutrophils and intracellular bacteria

A

Significantly reduced the mean lesion size of the eosinophilic plaques by 96% and indolent ulcers by 43% compared to the placebo

238
Q

Are SCORFAD and FEDSI reliable?

A
  • There is good interobserver reliability for both FEDESI and SCORFAD.
  • FEDESI and SCORFAD are positively correlated with one another and with pVAS
239
Q

Do plasma oclacitinib levels correlate with clinical response in cats?

A

No

240
Q

True or false; Systemic toxoplasmosis has been reported in immunocompetent adult cats, cats receiving ciclosporin or prednisolone for FASS and immunocompromised cats with feline immunodeficiency virus (FIV) or feline leukaemia virus

A

True

241
Q

SLIT for cats with FASS associated with HDM and storage mites significantly reduced SCORFAD and PVAS in what time frame?

A

3 months

242
Q

Intradermal injections of heat-killed actinomycetales (Gordonia bronchialis) led to a significant reduction in SCORFAD after 90 days. What is the proposed mechanism of action?

A

Multiple immunological effects

  • Activation of TLR-2 and lectin pathways
  • Inhibition of T helper (Th)2-mediated response
  • Increase T regulatory (Treg) cells.
  • Non-specific decrease in inflammation by downregulating NF-kappa-B (nuclear factor kappa light chain enhancer of activated B cells), chemokines (e.g. CCL20) and pro-inflammatory cytokines, such as IL-1b
243
Q

A single injection of a heat-killed suspension of __________ was found to be well tolerated and effective in treating mild to moderate cases of cAD demonstrable for 3 months, but was insignificant in more severely affected dogs.

A

Mycobacterium vaccae

244
Q

Name risk factors for developing AD in people

A
  • Urban lifestyle
  • Regions with low UV light
  • Dry climate
  • High sugar and polyunsaturated fatty acid diets
  • Repeated exposure to antibiotics before 5 yo
  • Small family size
  • High household education level
  • Familial history
245
Q

In people, which diseases is AD associated with?

A
  • Strongly associated: attention-deficit/hyperactivity disorder, depression, anxiety, conduct disorder, autism
  • Weakly associated: IBD, rheumatoid arthritis, AA, vitiligo
  • Modest association: cutaneous T cell lymphoma (severe forms of AD)
  • Diseases decreased in AD: type I diabetes mellitus, glioma, meningioma, acute lymphoblastic leukaemia (inhibition of Th17)
246
Q

Name genes involved in AD in people

A
  • FLG ( but, only ∼ 20% of patients with mild to moderate AD carry FLG mutations)
  • RAD50 (through epigenetic remodelling, regulates the expression of the surrounding type 2 immunity cytokines)
  • LRRC32 (causes a decrease expression of glycoprotein A- it binds TGF-𝛃)
247
Q

Name epidermal changes that are observed in lesional and nonlesional skin in AD patients

A
  • increased pH
  • reduced water retention
  • easy irritability
  • increased permeability to low molecular mass chemicals
  • increased susceptibility to infection
248
Q

Name molecular changes that are observed in lesional and nonlesional skin in AD patients

A
  • reduced expression of epidermal differentiation-related structural proteins
  • imbalances in protease-protease inhibitor interactions
  • altered composition and lamellar organization of epidermal lipids
  • reduced expression of tight junction proteins
  • altered surface microbiota colonization pattern (greater abundance of S. aureus)
249
Q

Name 2 theories that are being proposed for development of AD in people?

A
  1. INSIDE to OUTSIDE →immunological aberrations are believed to be primary initial event in the development and stimulation with allergens leads to weakening the epidermal barrier
  2. OUTSIDE to INSIDE → impaired skin barrier is the first step in atopic eczema’s pathogenesis and is required for immune dysregulation to occur
250
Q

What is epigenetics and how does it influence AD?

A
  • A study of gene expression regulations that are not related to the modification of DNA sequences
  • These modifications lead to the activation or inhibition of the transcription of specific genes, resulting in the translation of the new mRNA into a polypeptide chain
  • They influence the functioning, activation and polarization of cells and the ability to secrete cytokines
  • Changes in the epigenome may be permanent in the next generations
  • They consist of DNA methylation through miRNA and histone acetylation
251
Q

What are alarmins?

A

Alarmins are diverse group of proteins that are released in response to tissue damage and induce inflammation
- IL-1𝛃, IL-25, IL-33, TSLP

252
Q

Name 2 most common used scoring systems used in AD

A

SCORAD-Scoring Atopic Dermatitis

EASI-Eczema Area and Severity Index

253
Q

Name most commonly used emollients in people with AD

A
  • glycyrrhetinic acid
  • ceramide
  • palmitoylethanolamide
254
Q

When using topical corticosteroids, what is the most important bioassay indicative of anti-inflammatory potency?

A

Vasoconstriction assay-the higher the potency the greater the vasoconstriction

255
Q

Name only PDE4 inhibitor licenced in treatment of AD in people and its MOA?

A

Crisaborole ointment
- inhibits the PDE4 and promotes the activity of the second messenger cAMP, resulting in a decrease in the production of pro-inflammatory cytokines

256
Q

How does the dupilumab work and what are the most common side effects?

A
  • monoclonal antibody against IL-4R𝝰 that blocks both IL-4 and IL-13 signalling
  • ocular complaints (dry eye, conjunctivitis and blepharitis), nasopharyngitis, injection-site reactions
257
Q

Name most common complications of AD in people

A
  • S. aureus infection
  • Eczema herpecticum
  • Molluscum contagiosum
  • Eczema coxsackium
258
Q

When should oral prednisolone be withdrawn before IDT?

A

14 days (does not need withdrawal for serology)

259
Q

What dose of prednisolone can shorten the duration of a diet trial?

A

0.5 mg/kg SID or BID for three days, followed by 0.5 mg/kg daily for 5–17 days, then EOD for 6–8 days

260
Q

When should topical high potency steroids (HCA, triamcinolone) be withdrawn before IDT?

A

14 days

261
Q

When should oral antihistamines be withdrawn before IDT?

A

7-10 days

262
Q

What % of atopic dogs can be managed on BIW and EOD ciclosporin?

A

BIW 25-30%

EOD 35-40%

263
Q

When should oral ciclosporin be withdrawn before IDT?

A

Does not need to be withdrawn

264
Q

Is the administration of daily oclacitinib associated with neoplasia?

A

No

265
Q

Oclacitinib was able to shorten the elimination diet trial time with a provocation starting after ____ weeks and diagnosis within ____ weeks in most cases

A

Four

Six

266
Q

Proactive monthly lokivetmab prevented the development of clinical signs in what % of atopic dogs after 6-12 months of treatment?

A

33% 6 months

28% 12 months

267
Q

Which anti-pruritic medications can be used during serological or intradermal allergen testing?

A 
Oral glucocorticoids (serological tests only) 
Antihistamines (serological tests only) 
Ciclosporin 
Oclacitinib 
Lokivetmab
268
Q

Dogs diagnosed with AD had increased serum macrophage migration inhibition factor concentrations compared to control dogs; this difference was not observed in dogs that had been treated with what?

A

Steroids

269
Q

Do serum macrophage migration inhibition factor concentrations correlate with clinical scores in cAD?

A

No

270
Q

Using 2-3 weeks of prednisolone or oclacitinib at the start of an elimination diet trial can shorten the length of the trial in dogs showing 1 or less relapses off medication, what is the sens/spec of this test?

A

Sensitivity of 95% for prednisolone and 63% for oclacitinib.
Specificity was 100% for both drugs.

271
Q

Oclacitinib administered at the currently labelled dose for one year is associated with a significant increase in circulating CD4+T cells; does it affect antigen-stimulated cytokine production?

A

No

272
Q

Compared to long-term treatment with other anti-allergy drugs including ciclosporin, does oclacitinib increase the risk of neoplasia?

A

No - it does not pose an additional risk for malignancy in dogs

273
Q

What is the reported efficacy of ASIT in dogs?

A
  1. 9% - can improve clinical signs by ≥50%.

31. 5% managed on ASIT alone

274
Q

Which topical anaesthetic has been tested in IDT with no significant differences in mean wheal diameter for any evaluated allergen at any time point between the control and treated sides?

A

5% lidocaine

275
Q

What is a suggested theory why M. pachydermatitis is more abundant in the skin of atopic dogs compared to healthy dogs (M. restricta and M. globosa)?

A

Suggested to be driven by the decreased lipid content known to occur in the skin of dogs with CAD

276
Q

Which topical products have been shown to improve epidermal barrier integrity in cAD?

A

Allerderm spot-on
Dermoscent Essential 6
Atopivet
Douxo Calm (phytosphingosine and raspberry oil)
Allermyl (lipids, complex sugars, and antiseptic)

277
Q

Atopic people are more likely to be epileptic, is the same true in dogs?

A

Herrmann et al. (2021) observed an increased prevalence of seizure activity in the atopic dog population (34 dogs per group)

278
Q

Cugmas and Olivry (2021) found a strong correlation between erythema valuations using CADESI-04 a visual analogue scale and objective erythema index and a good agreement between the objective EI and CADESI-04-based estimates. How was the objective assessment performed?

A

Using a dermatoscope and smartphone

279
Q

Is time to effect of ASIT affected by the type of SCIT used?

A

Yes - Der f 2-pullulan (Der f2-P), polymerised allergoids coupled to a non-oxidized mannan (PAM) and tyrosine adjuvanted (TA)-based SCIT appear to have a similar-to-higher efficacy rate, and a shorter time to clinically-relevant reductions in pruritus (3 months) and/or skin lesions, than the currently available aqueous and alum precipitated-based SCIT (9 months or more in up to 20% of dogs)

280
Q

Name the major D. farinae allergens for dogs

A 
Low molecular weight allergens: 
Der f 1
Der f 2
High molecular weight allergens: 
Der f 15 
Der f 18
Zen-1
281
Q

Did intradermal testing agree with serum testing in dogs with no detectable anti-CCD IgE?

A

Yes - sera containing anti-CCD IgE had no agreement with IDT and test agreement was improved by blocking the anti-CCD IgE.

282
Q

What effect did 8 weeks of vitamin D treatment (cholecalciferol) have on atopic dogs?

A

Significantly reduced pruritus compared to placebo (palm oil) which strongly correlated with increased serum 25-hydroxycholecalciferol

283
Q

Did a product containing blackcurrant seed oil, heat-killed Lactobacillus reuteri, zincoxide and nucleotides (Ribes Pet Symbio™) affect pruritus and clinical scores in dogs with cAD?

A

Yes - reduced pruritus and lesions scores as well as reduced intestinal dysbiotic index

284
Q

Is CRP a biomarker in cAD?

A

No - lack of significant difference in CRP levels between dogs of increasing AD severity and lack of correlation between percentage changes in skin lesion and CRP values

285
Q

Did a diet fortified in antioxidants, polyphenols, and omega-3 fatty acids have more effect on dogs with cAD than a standard diet (Purina Proplan™ Opti Nutrition Adult)?

A

Yes - significantly lowered pruritus and CADESI scores in 60 days (alongside oclacitinib)

286
Q

Can IL-10 and TGF-beta be used to monitor response to ASIT in dogs?

A

No - no significant difference in IL-10 and TGF-ß1 between atopic and control dogs.

287
Q

Can miRNA expression be used as a biomarker of cAD?

A

No - cannot differentiate between cAD and other cause of skin inflammation

288
Q

What are micro (mi)RNAs?

A

Short, single-stranded RNA molecules of about 22 nucleotides in length, that play a role in the regulation of gene expression in a post-transcriptional fashion

289
Q

Is rush SCIT associated with more a/e than conventional SCIT induction?

A

Yes but they are mild in nature e.g. injection site reaction, increased pruritus

290
Q

Dogs on ILIT need ongoing therapy after an initial induction course?

A

Yes - low numbers may do well on a 1-3 ILIT injections per year but most will relapse once treatment is stopped

291
Q

What are the most common causes of blepharitis in the dog?

A
  1. Allergic skin disease (52%)
  2. Infectious/parasitic diseases (21.5%) e.g. demodicosis, dermatophytosis, leishmaniasis
  3. Autoimmune disorders (17.7%) SPGD, juvenile SPGD, DLE, SA, EM, PF, VKH
  4. Neoplasia (4.9%)
292
Q

Are brachycephalic dogs significantly more or less likely to present with blepharitis than other breeds?

A

More

293
Q

Are more female or male cats affected by FASS?

A

Females 58.4%

294
Q

How many body regions are observed in FEDESI and SCORFAD?

A 
FEDESI = 42
SCORFAD = 10
295
Q

SCORFAD is a validated scale for which reaction patterns ?

A
  1. Head and neck excoriations
  2. Miliary dermatitis
  3. Eosinophilic plaque
  4. self-induced alopecia
296
Q

What do FEDESI and SCORFAD not assess?

A

Oral cavity lesions!

297
Q

Can topical inhalation of fluticasone or budesonide suppress hypothalamic-pituitary-adrenal axis?

A

Budesonide

298
Q

In people, skin prick testing is less sensitive for venom allergy than IDT, why is it performed?

A

It has less risk of a/e

299
Q

Human serum ______ has been described as a predictor of anaphylaxis severity

A

Tryptase

300
Q

NAVDF Loewinger et al. (2021); did CBD/CBDA oil treatment have an effect on atopic dogs?

A

Reduced pruritus but not skin lesions over 28 days

301
Q

NAVDF Mcauliffe (2021); how is behaviour affected in dogs with AD?

A

Stranger- and owner-directed aggression, familiar-dog aggression, dog-directed fear, nonsocial fear, touch sensitivity, excitability and attention-seeking behaviours were increased, and trainability was decreased in the atopic dogs.

302
Q

NAVDF Canning (2021); Which drugs may reduce serum IgE levels on allergen testing?

A

Ciclosporin and lokivetmab

Also found no improved correlation between IDT and SAT after blocking CCD (contrast to previous studies!)

303
Q

NAVDF Ewing (2021); how effective is venom immunotherapy in dogs and what are the reported adverse effects?

A
  • Reduced severity of reactions in 87.8% of challenges.
  • Reduced severity of reactions at every challenge was reported in 80.7% of patients
  • a/e: GI upset (49.2%), and <10% each of lethargy, cutaneous erythema, urticaria, ptyalism, injection site discomfort, injection site abscess, papules, pruritus, facial oedema, and sensitisation to human serum albumin
304
Q

Has alopecia areata been reported in dogs with AD?

A

Yes - rarely

305
Q

What effect does early life exposure to HDM and bacterial endotoxin concentrations in the beddings of dogs have on development of AD?

A

Negative influence/correlation with development of AD

306
Q

What are the reported a/e of SCIT in cats?

A
  1. Pruritus
  2. Vomiting/diarrhoea
  3. Local injection reaction
  4. Sudden death, collapse, dyspnea and anaphylaxis - Appearance of the acute AE after SCIT was within 48 hr in ~80%
307
Q

Can EOD use of oclacitinib effectively control AD in dogs?

A

Yes

Sarah - Mulller and Kirk (14 decks)

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