Fosfolipidit hevosen kesäihottumassa ja sen hoidossa

Summer eczema is one of the most common diseases that causes discomfort and impairs the quality of life of horses worldwide. The lack of a feasible treatment has made this recurrent, insect hypersensitivity-linked allergic pruritus a challenge for veterinary medicine. The first aim of this study was to examine serum phospholipids and their use in the therapy of summer eczema by using an autologous serum preparation. The second aim was to delineate clinical features of summer eczema among Finnhorses. The efficacy of the therapy was investigated in 28 horses in a placebo-controlled study and was also evaluated according to long-term information collected from the owners of the 343 horses treated with this therapy over 12 years. Serum phospholipids and their changes after autoserum therapy were analysed in 10 horses with summer eczema and 10 matched healthy controls by LC-MS. Content of phospholipids in autoserum preparations of 10 affected and 6 healthy horses were analysed by ESI-MS. Horses in the placebo group showed significant aggravation in their clinical signs compared with horses treated with autoserum therapy at the same time (P=0.0329). According to long-term data, 70% of the horses benefited from this autoserum therapy (95% CI 0.64-0.75, P<0.0001) and 16% did not, and 14% of the owners did not provide a clear opinion. No harmful side effects were observed. Horses with summer eczema displayed significantly lower concentrations of phosphatidylcholine (P<0.0001) and sphingomyelin (P=0.0115) in their sera than healthy horses. After a 4-week autoserum therapy, no significant difference between these horses could be demonstrated. The change in clinical signs correlated significantly with the alterations in sphingomyelin concentrations (P=0.0047). Analysis of autoserum preparations revealed that these preparations contained major serum phospholipids, however, in significantly differing concentrations between eczema and healthy horses. Affected horses showed more abundant concentrations of phosphatidylcholine (P=0.042) and sphingomyelin (P=0.0017). In addition, concentrations of these phospholipids correlated significantly with the clinical status. Finnhorses formed the largest group. Most Finnhorses had become affected before the age of 5 years and showed moderate signs. Severity of the signs was not related to age at onset. No significant correlation existed between duration and severity of the disease. This study showed that an autoserum preparation containing serum phospholipids was a favourable method to treat summer eczema. Affected horses displayed significant differentiations in their serum phospholipid profiles and these alterations seemed to change according to the clinical status. Applications of this autoserum therapy for other allergic manifestations of horses should be explored.Kesäihottuma on yleisin hevosen elämänlaatua heikentävä allerginen ihosairaus. Kesäihottumaa tavataan kaikkialta maailmasta siellä, missä hevoset altistuvat polttiaisten pistoille. Suomessa tämä aika ulottuu yleensä toukokuusta lokakuuhun ja sen takia sairaudesta käytetään meillä nykyisin nimitystä kesäihottuma entisten kutka tai hankuri sijaan. Tähän kesäisin toistuvaan kutinaan ei ole toistaiseksi ollut sopivaa hoitoa. Tämän tutkimuksen tarkoituksena oli selvittää seerumin rasvoihin kuuluvien, ns. fosfolipidien, eroja kesäihottumaa sairastavilla ja terveillä hevosilla sekä näiden lipidien käyttöä kesäihottuman hoitoon. Fosfolipidit ovat rasvoja, jotka osallistuvat useisiin elimistön puolustusjärjestelmän reaktioihin. Lisäksi kartoitettiin kesäihottuman kliinistä kuvaa omalla kansallisella hevosrodullamme, suomenhevosella. Seerumin ja kunkin hevosen omasta seerumista tehdyn hoitovalmisteen, ns. seerumivalmisteen, fosfolipidien laatua ja pitoisuutta analysoitiin massaspektrometrisin menetelmin. Seerumivalmisteen tehoa selvitettiin kaksoissokkotutkimuksella ja kokemuksia seerumivalmisteen käytöstä kerättiin 12 vuoden ajalta. Koska kyseessä oli maailmanlaajuisestikin uusi hoitomuoto, oli tarpeellista koota hoitoon liittyvää tietoa pitkältä ajanjaksolta. Hevosen seerumissa runsaimmin esiintyvien fosfolipidien pitoisuudet olivat kesäihottumaa sairastavilla hevosilla merkitsevästi alhaisempia verrattuna terveisiin. Neljän viikon seerumivalmistehoidon jälkeen ei eroa ollut enää. Toisin kuin seerumi, sairaiden hevosten seerumivalmiste sisälsi merkitsevästi enemmän näitä fosfolipidejä verrattuna terveiden seerumista tehtyyn valmisteeseen. Lisäksi seerumivalmisteen fosfolipidipitoisuudella ja oireiden voimakkuudella havaittiin selvä yhteys. Kaksoissokkotutkimuksessa 4 viikon tutkimusjakson jälkeen lumevalmisteella hoidettujen hevosten oireet pahenivat merkitsevästi verrattuna seerumivalmisteella hoidettuihin. Omistajilta kerätyn tiedon perusteella seerumivalmistetta saaneista 343 hevosesta 70 % oli saanut apua, 16 % ei ja 14 % omistajista ei ilmaissut selvää kantaa. Haitallisia sivuvaikutuksia ei todettu. Suomenhevosilla kesäihottuma puhkesi tavallisesti 5 ikävuoteen mennessä, ja useimmilla oireet olivat kohtalaisen voimakkaita, vain 11 % kärsi kaikkein vaikeimmista oireista. Merkitsevää yhteyttä oireiden voimakkuudella ja sairastumisiällä ei havaittu eikä myöskään sairastettujen kesien määrällä ja sairauden voimakkuudella. Tämä tutkimus osoitti, että kesäihottumaa sairastavilla hevosilla on poikkeava seerumin fosfolipidiprofiili, joka muuttuu oireiden lievenemisen myötä, ja että fosfolipidejä sisältävää valmistetta voidaan käyttää allergisen ihosairauden hoitoon ilman sivuvaikutuksia. Hoitoa voisi soveltaa myös muihin hevosen allergisiin sairauksiin

Lipidomics: The Function of Vital Lipids in Embryogenesis Preventing Autism Spectrum Disorders, Treating Sterile Inflammatory Diatheses with a Lymphopoietic Central Nervous System Component

The central role performed by billions of vital central nervous system (CNS) lipids “lipidomics” in medical physiology is usually overlooked. A metabolic deficiency embracing these vital lipids can form the aetiology for a variety of diseases. CNS lipids regulate embryogenesis, cell induction, mental balance by preventing autism spectrum disorders, depression, burn-out syndromes like posttraumatic stress disease PTSD, by guarding normal immunity, treating sterile inflammatory diatheses with a titanium containing lymphopoietic CNS lipid component. The propaganda driving for unphysiological fat-free diets is dangerous and can cause serious health problems for a whole generation. This article presents a broad list of various mental and motor bodily functions of which the healthy function depends on these vital CNS lipids. A rigorous fat-free diet can provoke these metabolic lipid deficiencies but they can fortunately be compensated by dietary supplementation, but not by pharmacologic treatment

Phospholipid analysis in sera of horses with allergic dermatitis and in matched healthy controls

Background: Lipids have become an important target for searching new biomarkers typical of different autoimmune and allergic diseases. The most common allergic dermatitis of the horse is related to stings of insects and is known as insect bite hypersensitivity (IBH) or summer eczema, referring to its recurrence during the summer months. This intense pruritus has certain similarities with atopic dermatitis of humans. The treatment of IBH is difficult and therefore new strategies for therapy are needed. Autoserum therapy based on the use of serum phospholipids has recently been introduced for horses. So far, serum lipids relating to these allergic disorders have been poorly determined. The main aim of this study was to analyse phospholipid profiles in the sera of horses with allergic dermatitis and in their healthy controls and to further assess whether these lipid profiles change according to the clinical status after therapy. Methods: Sera were collected from 10 horses with allergic dermatitis and from 10 matched healthy controls both before and 4 weeks after the therapy of the affected horses. Eczema horses were treated with an autogenous preparation made from a horse's own serum and used for oral medication. Samples were analysed for their phospholipid content by liquid chromatography coupled to a triple-quadrupole mass spectrometer (LC-MS). Data of phospholipid concentrations between the groups and over the time were analysed by using the Friedman test. Correlations between the change of concentrations and the clinical status were assessed by Spearman's rank correlation test. Results: The major phospholipid classes detected were phosphatidylcholine (PC), sphingomyelin (SM), phosphatidylinositol (PI) and phosphatidylethanolamine (PE). Eczema horses had significantly lower total concentrations of PC (p <0.0001) and SM (p = 0.0115) than their healthy controls. After a 4-week therapy, no significant differences were found between the groups. Changes in SM concentrations correlated significantly with alterations in clinical signs (p = 0.0047). Conclusions: Horses with allergic dermatitis have an altered phospholipid profile in their sera as compared with healthy horses and these profiles seem to change according to their clinical status. Sphingomyelin seems to have an active role in the course of equine insect bite hypersensitivity.Peer reviewe

Characteristics of equine summer eczema with emphasis on differences between Finnhorses and Icelandic horses in a 11-year study

Summer eczema, allergic dermatitis of the horse, was studied on 275 affected horses in Finland in 1997–2007. Features of the horses, clinical signs of the disease and owners' opinions of aggravating factors were recorded. Differences, especially, between two of the native Scandinavian horse breeds, the Finnhorse and the Icelandic horse, were evaluated. The study was based on clinical examination and information from the owners. Of the horses, 50% were Finnhorses, 26% Icelandic horses and 24% consisted of different breeds of ponies and other horses. Of the Finnhorses, 76% had summer eczema by the age of 5 years, but in the Icelandic horses born in Finland the average age at onset was 7 years. The vast majority of the horses, 75%, had moderate clinical signs, while 16% showed severe and 9% mild. The severity of clinical signs did not depend on the duration of the disease nor was it related to the age at onset. The only linkage to severity was the breed of the horse or import from Iceland; New Forest ponies and imported Icelandic horses showed severe clinical signs significantly more often than Finnhorses. Of the owners, 38% regarded insects as the only aggravating factor, 24% mentioned several simultaneous factors, including grass fodder and sunlight, while 22% could not specify any. In Finland, a typical horse breed suffering from summer eczema is the Finnhorse and the characteristics of the disease are mainly uniform with the other breeds affected. Equine summer eczema seems to be aggravated by various combinations of environmental factors