Publicação
Epicutaneous immunotherapy as a novel route of allergen administration in dogs with atopic dermatitis : a proof-of-concept study
| Resumo: | ABSTRACT - Allergen immunotherapy is a well-established treatment for canine atopic dermatitis (CAD), but new non-invasive, safe, effective and at-home easy-to-use vaccine-delivery routes that promote compliance are needed. Epicutaneous immunotherapy (EPIT) is a new promising alternative route that takes advantage of the skin’s unique immunological features and high accessibility. Our goal was to assess the feasibility, efficacy, and safety of EPIT in CAD. Sixteen dogs (9 French bulldog (FB) and 7 labrador retriever (LR) dogs) with spontaneous non seasonal CAD and positive allergen-specific IgE (sIgE) serology for domestic mites (HDM) were enrolled for a weekly, 12-hour allergen-containing patch application, over 12 weeks. A costume-made 3D-printed device was developed to incorporate the allergen-based formulation, which included a tailor-made vehicle to enhance allergen penetration into the skin. The primary efficacy outcomes were the owner-assessed pruritus manifestations (PVAS10), veterinarian-assessed skin lesions (2D-IGA), and the owner’s perceived treatment efficacy (OGATE and OGES). Secondary efficacy outcomes were the quality-of-life (QoL), sIgE and IL 10 concentrations. The EPIT safety evaluation considered both local and systemic adverse reactions. Treatment efficacy was defined by the primary outcome measures’ success, according to the ICADA’s COSCAD’18 recommendations. EPIT was deemed safe if no severe local and systemic side-effects occurred. The owner’s compliance with the proposed protocol and required study appointments were monitored and their overall satisfaction was estimated. One LR dog dropped out. All dogs improved their pruritus scores, and 13/15 dogs (86.67%) were successful in the terms considered for this study [FB=8/9 (88.89%); LR=5/6 (83.33%)]. Moreover, 8/12 dogs [66.67%; FB=5/8 (62.5%); LR=3/4 (75%)] reached the level considered successful in the skin lesions’ sore. The response to EPIT was rated as good-to-excellent by 13/15 owners (86.67%) in the OGATE survey and by 11/15 owners (73.33%) in the OGES survey. An improvement in the QoL scores was reported by 13/15 owners (86.67%), with a percentage mean improvement of 54.58%. sIgE values overall decreased in 10/15 dogs (66.67%) and 2/15 dogs (13.33%) desensitised to all HDM to which they were previously allergic. Non-conclusive IL-10 results were obtained. No systemic or local severe adverse events were recorded. EPIT was well received by the owners of the 15 dogs, who fully complied with the proposed protocol. This pilot study emphasizes the EPIT’s great potential as an effective and safe CAD treatment, supporting further investigation on this novel therapy. |
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| Autores principais: | Pinto, Marta |
| Assunto: | Atopic dermatitis Epicutaneous immunotherapy Iimmunologic desensitization Skin Dogs Dermatite atópica Imunoterapia epicutânea Dessensibilização imunológica Pele Cães |
| Ano: | 2021 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | ABSTRACT - Allergen immunotherapy is a well-established treatment for canine atopic dermatitis (CAD), but new non-invasive, safe, effective and at-home easy-to-use vaccine-delivery routes that promote compliance are needed. Epicutaneous immunotherapy (EPIT) is a new promising alternative route that takes advantage of the skin’s unique immunological features and high accessibility. Our goal was to assess the feasibility, efficacy, and safety of EPIT in CAD. Sixteen dogs (9 French bulldog (FB) and 7 labrador retriever (LR) dogs) with spontaneous non seasonal CAD and positive allergen-specific IgE (sIgE) serology for domestic mites (HDM) were enrolled for a weekly, 12-hour allergen-containing patch application, over 12 weeks. A costume-made 3D-printed device was developed to incorporate the allergen-based formulation, which included a tailor-made vehicle to enhance allergen penetration into the skin. The primary efficacy outcomes were the owner-assessed pruritus manifestations (PVAS10), veterinarian-assessed skin lesions (2D-IGA), and the owner’s perceived treatment efficacy (OGATE and OGES). Secondary efficacy outcomes were the quality-of-life (QoL), sIgE and IL 10 concentrations. The EPIT safety evaluation considered both local and systemic adverse reactions. Treatment efficacy was defined by the primary outcome measures’ success, according to the ICADA’s COSCAD’18 recommendations. EPIT was deemed safe if no severe local and systemic side-effects occurred. The owner’s compliance with the proposed protocol and required study appointments were monitored and their overall satisfaction was estimated. One LR dog dropped out. All dogs improved their pruritus scores, and 13/15 dogs (86.67%) were successful in the terms considered for this study [FB=8/9 (88.89%); LR=5/6 (83.33%)]. Moreover, 8/12 dogs [66.67%; FB=5/8 (62.5%); LR=3/4 (75%)] reached the level considered successful in the skin lesions’ sore. The response to EPIT was rated as good-to-excellent by 13/15 owners (86.67%) in the OGATE survey and by 11/15 owners (73.33%) in the OGES survey. An improvement in the QoL scores was reported by 13/15 owners (86.67%), with a percentage mean improvement of 54.58%. sIgE values overall decreased in 10/15 dogs (66.67%) and 2/15 dogs (13.33%) desensitised to all HDM to which they were previously allergic. Non-conclusive IL-10 results were obtained. No systemic or local severe adverse events were recorded. EPIT was well received by the owners of the 15 dogs, who fully complied with the proposed protocol. This pilot study emphasizes the EPIT’s great potential as an effective and safe CAD treatment, supporting further investigation on this novel therapy. |
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