References
Novel developments in equine asthma
Abstract
Equine asthma is a disease which affects horses across the globe and can range from mild exercise impairment to severe debilitation that decreases the horse's quality of life. Treatment currently focuses on environmental management, bronchodilators and systemic and inhaled glucocorticosteroids. Glucocorticosteroids remain the mainstay of therapy but can have deleterious side effects; therefore, there is a critical need for the development of new therapies. Nebulised lidocaine and immunomodulatory therapy both hold promise for the treatment of equine asthma, especially with respect to avoiding the deleterious effects of glucocorticosteroids.
Equine asthma (previously called inflammatory airway disease, recurrent airway obstruction or heaves) is an endemic condition in horses and is characterised by non-septic airway inflammation and hyper-reactivity leading to increased mucus production, secretions and a chronic cough, causing poor health and performance (Couëtil et al, 2020). Equine asthma is a global disease that can occur in all climates with increased risk associated with high levels of ambient pollens and moulds, such as in the south of the USA. Equine asthma encompasses a spectrum of clinical presentations from mild to severe, although it is unclear whether the pathogenesis of disease differs between severity levels, and can be a major cause of poor performance (Ivester et al, 2018) and poor quality of life. Mild asthma mostly encompasses the occasional cough (mostly at exercise) with normal breathing at rest, while severe asthma can cause debilitating disease at rest with increases in both respiratory rate and effort, and all forms of equine asthma are the result of a chronic condition lasting from weeks to months, often presenting as a recurrent problem (Couëtil et al, 2020). While treatment with glucocorticosteroids is the most common and reliable pharmaceutical approach to equine asthma, it can be associated with significant systemic side effects and endocrine-related morbidity in at-risk horses (Bailey, 2010). There is a need for the development of new, efficacious treatments of equine asthma because of these deleterious side effects, and current research is heavily focused on novel therapies.
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