Tierarztl Prax Ausg K Kleintiere Heimtiere 2014; 42(03): 162-173
DOI: 10.1055/s-0038-1623762
Original Article
Schattauer GmbH

Efficacy and safety of rush immunotherapy with alumprecipitated allergens in canine atopic dermatitis

Wirksamkeit und Sicherheit von Rush-Immuntherapie mit alumpräzipitierten Allergenen bei atopischer Dermatitis des Hundes
S. Hobi
1   Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
,
Ralf S. Mueller
1   Small Animal Medicine Clinic, Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
› Author Affiliations
The authors would like to thank the doctoral students of the Dermatology Service/Center for Clinical Veterinary Medicine, Ludwig Maximilian University Munich and our veterinary technician A. von Voigts-Rhetz for supporting the study and monitoring our stationary patients.
Further Information

Publication History

Received: 02 December 2013

Accepted after revision: 24 February 2014

Publication Date:
06 January 2018 (online)

Summary

Objectives: Canine atopic dermatitis is a very common disease in small animal practice. Its only specific treatment is allergen immunotherapy. In rush-immunotherapy (RIT) increasing doses of allergen extract are injected subcutaneously in short intervals. Maintenance doses are achieved within one day compared to weeks or months with conventional immunotherapy. The aim of this study was to evaluate the safety and efficacy of RIT with alum-precipitated allergens. Materials and methods: A series of 20 dogs with atopic dermatitis underwent RIT with alum-precipitated allergens. Pruritus and medications at the start of the immunotherapy and 12 months afterwards were compared and adverse effects were recorded. Results: Significant improvement in pruritus (p = 0.0001) and medication scores (p = 0.0004) was noted after approximately 12 months of treatment. The observed clinical response was good to excellent in 70% of the dogs, consistent with other published reports. One dog vomited once during the induction day, with no other clinical problems and completion of the normal protocol. The other 19 dogs showed no adverse effects at all during or after RIT. Conclusion and clinical relevance: RIT with alum-precipitated allergens seems to be a safe and efficacious method to treat dogs with atopic dermatitis.

Zusammenfassung

Gegenstand und Ziel: Die atopische Dermatitis des Hundes stellt eine häufige Erkrankung in der Kleintierpraxis dar. Die einzige ursächliche Therapie ist eine allergenspezifische Immuntherapie. Bei der Rush-Immuntherapie (RIT) werden aufsteigende Dosen von Allergenen in relativ kurzer Zeit bis zur Erhaltungsdosis subkutan appliziert. Die Erhaltungdosis wird bereits nach einem Tag erreicht, während dies bei der konventionellen Methode Wochen bis Monate dauert. Ziel dieser Studie war, die Sicherheit und Wirksamkeit einer RIT mit alumpräzipitierten Allergenen zu prüfen. Material und Methoden: Insgesamt 20 Hunde mit atopischer Dermatitis wurden mit RIT unter Verwendung alumpräzipitierter Allergene behandelt. Pruritus und Medikationen vor und ungefähr 12 Monate nach Beginn der Therapie wurden verglichen und Nebenwirkungen dokumentiert. Ergebnisse: Eine signifikante Verbesserung des Juckreizes (p = 0,0001) und des Medikamentenscores (p = 0,0004) konnte nach einer Behandlungszeit von ungefähr 12 Monaten festgestellt werden. Die klinische Verbesserung war bei 70% der Hunde gut bis hervorragend, was mit bereits publizierten Daten übereinstimmt. Ein Hund erbrach während der Induktionsphase einmalig, konnte aber die RIT ohne weitere Probleme beenden. Die restlichen 19 Hunde hatten keine Probleme während oder nach der RIT. Schlussfolgerung und klinische Relevanz: Die RIT scheint eine sichere und wirksame Methode zur Behandlung der atopischen Dermatitis bei Hunden zu sein.

 
  • References

  • 1 Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2011; 127 (01) 18-27.
  • 2 Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2007; 119 (04) 780-791.
  • 3 Colombo S, Hill PB, Shaw DJ, Thoday KL. Effectiveness of low dose immunotherapy in the treatment of canine atopic dermatitis: a prospective, double-blinded, clinical study. Vet Dermatol 2005; 16 (03) 162-170.
  • 4 Dell DL, Griffin CE, Thompson LA, Griffies JD. Owner assessment of therapeutic interventions for canine atopic dermatitis: a long-term retrospective analysis. Vet Dermatol 2012; 23 (03) 228-e47.
  • 5 Favrot C, Steffan J, Seewald W, Picco F. A prospective study on the clinical features of chronic canine atopic dermatitis and its diagnosis. Vet Dermatol 2010; 21 (01) 23-31.
  • 6 Fujita H, Soyka MB, Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy. Clin Transl Allergy 2012; 02 (01) 2.
  • 7 Griffin CE, Hillier A. The ACVD task force on canine atopic dermatitis (XXIV): allergen-specific immunotherapy. Vet Immunol Immunopathol 2001; 81 3–4: 363-383.
  • 8 Hammerberg B, Bevier D, DeBoer DJ, Olivry T, Orton SM, Gebhard D, Vaden SL. Auto IgG anti-IgE and IgG x IgE immune complex presence and effects on ELISA-based quantitation of IgE in canine atopic dermatitis, demodectic acariasis and helminthiasis. Vet Immunol Immunopathol 1997; 60 1–2: 33-46.
  • 9 Hill PB, DeBoer DJ. The ACVD task force on canine atopic dermatitis (IV): environmental allergens. Vet Immunol Immunopathol 2001; 81 3–4: 169-186.
  • 10 Jackson HA, Orton SM, Hammerberg B. IgE is present on peripheral blood monocytes and B cells in normal dogs and dogs with atopic dermatitis but there is no correlation with serum IgE concentrations. Vet Immunol Immunopathol 2002; 85 3–4: 225-232.
  • 11 Keppel KE, Campbell KL, Zuckermann FA, Greeley EA, Schaeffer DJ, Husmann RJ. Quantitation of canine regulatory T cell populations, serum interleukin-10 and allergen-specific IgE concentrations in healthy control dogs and canine atopic dermatitis patients receiving allergen-specific immunotherapy. Vet Immunol Immunopathol 2008; 123 3–4: 337-344.
  • 12 Kim HJ, Kang MH, Park HM. Common allergens of atopic dermatitis in dogs: comparative findings based on intradermal tests. J Vet Sci 2011; 12 (03) 287-290.
  • 13 Lauber B, Molitor V, Meury S, Doherr MG, Favrot C, Tengvall K, Bergvall K, Leeb T, Roosje P, Marti E. Total IgE and allergen-specific IgE and IgG antibody levels in sera of atopic dermatitis affected and non-affected Labrador- and Golden retrievers. Vet Immunol Immunopathol 2012; 149 1-2: 112-118.
  • 14 Loewenstein C, Mueller RS. A review of allergen-specific immunotherapy in human and veterinary medicine. Vet Dermatol 2009; 20 (02) 84-98.
  • 15 MacDonald JM. Rush hyposensitization in the treatment of canine atopy. Proceedings of the 15th Annual Meeting of the American Academy of Veterinary Dermatology/American College of Veterinary Dermatology. Maui, HI: 1999: 95-97.
  • 16 Mueller RS, Bettenay SV, Tideman L. Aero-allergens in canine atopic dermatitis in southeastern Australia based on 1000 intradermal skin tests. Aust Vet J 2000; 78 (06) 392-399.
  • 17 Mueller RS, Bettenay SV. Evaluation of the safety of an abbreviated course of injections of allergen extracts (rush immunotherapy) for the treatment of dogs with atopic dermatitis. Am J Vet Res 2001; 62 (03) 307-310.
  • 18 Mueller RS, Fieseler KV, Fettman MJ, Zabel S, Rosychuk RA, Ogilvie GK, Greenwalt TL. Effect of omega-3 fatty acids on canine atopic dermatitis. J Small Anim Pract 2004; 45 (06) 293-297.
  • 19 Mueller RS, Fieseler KV, Zabel S, Rosychuk RAW. Conventional and rush immunotherapy in canine atopic dermatitis. In: Advances in Veterinary Dermatology. Hillier A, Foster AP, Kwochka KW. eds. Oxford: Blackwell; 2005: 60-69.
  • 20 Nelson HS. Long-term immunotherapy with aqueous and aluminum-precipitated grass extracts. Ann Allergy 1980; 45 (06) 333-337.
  • 21 Norman PS, Lichtenstein LM. Comparisons of alum-precipitated and unprecipitated aqueous ragweed pollen extracts in the treatment of hay fever. J Allergy Clin Immunol 1978; 61 (06) 384-389.
  • 22 Nuttall T, Uri M, Halliwell R. Canine atopic dermatitis – what have we learned?. Vet Rec 2013; 172 (08) 201-207.
  • 23 Nuttall TJ, Thoday KL, van den Broek AH, Jackson HA, Sture GH, Halliwell RE. Retrospective survey of allergen immunotherapy in canine atopy. Vet Rec 1998; 143 (05) 139-142.
  • 24 Olivry T, DeBoer DJ, Favrot C, Jackson HA, Mueller RS, Nuttall T, Prelaud P. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis. Vet Dermatol 2010; 21 (03) 233-248.
  • 25 Olivry T, Bizikova P. A systematic review of randomized controlled trials for prevention or treatment of atopic dermatitis in dogs: 2008-2011 update. Vet Dermatol 2013; 24 (01) 97-117 e125–116.
  • 26 Patterson R, Harris KE. Rush immunotherapy in a dog with severe ragweed and grass pollen allergy. Ann Allergy Asthma Immunol 1999; 83 (03) 213-216.
  • 27 Picco F, Zini E, Nett C, Naegeli C, Bigler B, Rufenacht S, Roosje P, Gutzwiller ME, Wilhelm S, Pfister J, Meng E, Favrot C. A prospective study on canine atopic dermatitis and food-induced allergic dermatitis in Switzerland. Vet Dermatol 2008; 19 (03) 150-155.
  • 28 Prélaud PGE, Alhaidari Z. Reevaluation of diagnostic criteria of canine atopic dermatitis. Rev Med Vet 1998; 149 (11) 1057-1064.
  • 29 Willemse A, Van den Brom WE, Rijnberk A. Effect of hyposensitization on atopic dermatitis in dogs. J Am Vet Med Assoc 1984; 184 (10) 1277-1280.
  • 30 Willemse T. Atopic skin disease: a review and reconsideration of diagnostic criteria. J Small Anim Pract 1986; 27 (11) 771-778.
  • 31 Willemse T, Bardagi M, Carlotti DN, Ferrer L, Fondati A, Fontaine J, Leistra M, Noli C, Ordeix L, Scarampella F, Schleifer S, Sinke J, Roosje P. Dermatophagoides farinae-specific immunotherapy in atopic dogs with hypersensitivity to multiple allergens: a randomised, double blind, placebo-controlled study. Vet J 2009; 180 (03) 337-342.
  • 32 Zur G, Ihrke PJ, White SD, Kass PH. Canine atopic dermatitis: a retrospective study of 266 cases examined at the University of California, Davis, 1992–1998. Part I. Clinical features and allergy testing results. Vet Dermatol 2002; 13 (02) 89-102.