Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA)

Background: In 2010, the International Task Force on Canine Atopic Dermatitis (now International Committee on Allergic Diseases of Animals, ICADA) published the first consensus guidelines for the treatment of atopic dermatitis (AD) in dogs. This is the first 5-year minor update of this document. Results: The treatment of acute flares of AD should involve the search for, and then elimination of, the cause of the flares, bathing with mild shampoos, and controlling pruritus and skin lesions with interventions that include topical and/or oral glucocorticoids or oclacitinib. For chronic canine AD, the first steps in management are the identification and avoidance of flare factors, as well as ensuring that there is adequate skin and coat hygiene and care;this might include more frequent bathing and possibly increasing essential fatty acid intake. The medications currently most effective in reducing chronic pruritus and skin lesions are topical and oral glucocorticoids, oral ciclosporin, oral oclacitinib, and, where available, injectable recombinant interferons. Allergen-specific immunotherapy and proactive intermittent topical glucocorticoid applications are the only interventions likely to prevent or delay the recurrence of flares of AD. Conclusions: This first 5-year minor update of the international consensus guidelines for treatment of AD in dogs further establishes that the treatment of this disease is multifaceted, and that interventions should be combined for a proven (or likely) optimal benefit. Importantly, treatment plans are likely to vary between dogs and, for the same dog, between times when the disease is at different stages

Determination of CADESI-03 thresholds for increasing severity levels of canine atopic dermatitis

To evaluate the extent and severity of skin lesions in clinical trials enrolling dogs with atopic dermatitis (AD), the International Task Force on Canine Atopic Dermatitis recently recommended the use of the third version of the CADESI. This version of the CADESI was found to exhibit acceptable content, construct, criterion, inter- and intraobserver reliability and sensitivity to change. The current study was aimed at determining optimal CADESI-03 cut-off points to separate AD severity categories for future clinical trials. One hundred and eight dogs with AD were selected based on current diagnosis standards. At one or more visits, clinicians subjectively rated the severity of AD as 'in remission', 'mild', 'moderate' or 'severe', and a CADESI-03 score was then determined. In all, 158 CADESI-03 values were recorded and divided among the four disease severity categories. Receiver-operating characteristics (ROC) curves were generated at increasing cut-off values to determine the benchmark that would offer optimal sensitivity and specificity between adjacent categories. Cut-offs of 16, 60 and 120 are proposed at the interface of remission, mild, moderate and severe categories, respectively. Proposed intervals therefore are: remission: 0-15; mild AD: 16-59; moderate AD: 60-119; and severe AD: >/= 120. This Task Force recommends that, whenever applicable and relevant, subgroup analyses of outcome measures, based on disease severity as determined with these cut-off CADESI-03 values, be preplanned for clinical trials enrolling dogs with AD. Such subgroup analyses could help determine whether specific interventions might be more effective in a particular subset of atopic dogs

The novel high molecular weight Dermatophagoides farinae protein Zen-1 is a major allergen in North American and European mite allergic dogs with atopic dermatitis

BACKGROUND Atopic dogs with hypersensitivity to Dermatophagoides farinae (Df) have IgE recognizing high molecular weight (MW) allergens more often than the low MW Der f 1 and 2. A new high MW Df allergen, Zen-1, has been identified recently. OBJECTIVES To determine the IgE reactivity of American and European Df-hypersensitive dogs to Zen-1, Der f 1 and Der f 2. METHODS We tested sera from 33 Df-reactive dogs from the USA, 29 from Europe and 15 experimentally sensitized to Df, by ELISA against crude Df, Der f 1, Der f 2 and Zen-1. ELISA inhibition was performed with sera reactive to Zen-1. Intradermal testing (IDT) was also done with the same allergens in 25 other American atopic dogs. RESULTS Altogether, IgE seropositivity to Zen-1 was more prevalent (86%) than that to Der f 1 (17%) or Der f 2 (19%). The IgE reactivity to Zen-1 was correlated to that against crude Df; this allergen alone inhibited a high percentage (median: 50%; range: 22-84%) of the binding to the crude mite extract. The seropositivity to low MW allergens was highest in experimentally sensitized dogs. Serum IgE recognition of Der f 1 was low in dogs with AD; that to Der f 2 was significantly lower in American dogs (6%) than in European ones (28%). A high prevalence of positive immediate IDT reactions to Zen-1 confirmed the likely relevance of serological results. CONCLUSIONS AND CLINICAL IMPORTANCE This study establishes Zen-1 as a major allergen in atopic dogs sensitized to Df