Kedilerin Atopik Sendromuna Güncel Yaklaşım

Kedilerin atopik sendromu, kedilerin solunum veya temas yoluyla maruz kalabildiği ve çevresel alerjenlerden kaynaklı aşırı duyarlılığın tetiklenmesi ile ortaya çıkan bir tablodur. Köpeklerde görülen atopik dermatitise benzer özellikler taşıyan atopik sendromun, genetik yatkınlığa sahip, genellikle 5 yaş altındaki kedilerde rastlanabilen inflamatuar, kaşıntılı, immunglobulin E ve çevresel alerjenlere karşı oluşturulan antikorlarla ilişkili olduğu bilinmektedir. Siyam, Persiyan ve Himalayan gibi kedi ırkları kedi atopik sendromuna yatkınlık göstermektedir. Kedi atopik sendromu klinik açıdan milier dermatitis, eozinofilik granülom, iltihaplı olmayan alopesi veya ülseratif ve kabuklu dermatitis ile benzerlik göstermektedir. Bu sendromun kutanöz olmayan klinik bulguları arasında sinüzit, kedi astımı ve konjuktivitis bulunmaktadır. İntradermal alerji ve IgE ELISA testleri atopik sendromun tanısında kullanılmaktadır. Kedi atopik sendromun tanısında gıda alerjisi veya pire ısırığı aşırı duyarlılığı gibi nedenlerin elimine edilmesi önemlidir. Bunun yanı sıra tanıda biyofiziksel parametrelerden olan transepidermal su kaybı yaygın olarak kullanılmaktadır. Nedenin ortadan kaldırılması, hipoalerjenik diyet, glukokortikoid, siklosporin, oklakitinib, bronkodilatatör, antimikrobiyal ve antihistaminik uygulamaları tedavi seçenekleri arasındadır. Son zamanlarda atopik karakterli dermatitlerde alerjik solunum ve kutanöz hastalıklarının klinik belirtilerinin kontrol altına alınmasında alerjene özgü immünoterapinin kullanımı yaygınlaşmaktadır. Hastalıkta kullanılan tedavi seçeneklerinin bireysel farklılıklara göre değerlendirilmesi unutulmaması gereken bir noktadır. Bu derleme makalesi alerjik dermatite sahip kedilerde yaygınlaşmaya başlayan kedi atopik sendromun önemine vurgu yapmayı amaçlamaktadır.
Anahtar Kelimeler:

Alerjen, Atopi, IgE, Immunoterapi, Kedi

Current Approach To Feline Atopic Syndrome

Feline atopic syndrome is a condition in which cats can be exposed through breathing or contact, triggering hypersensitivity from environmental allergens. Atopic syndrome, which has characteristics similar to atopic dermatitis seen in dogs, is known to be associated with antibodies created against inflammatory, itchy, immunoglobulin E and environmental allergens that are usually found in cats under 5 years of age with a genetic predisposition. Breeds such as Siamese, Persian and Himalayan are predisposed to feline atopic syndrome. Feline atopic syndrome is clinically similar to milier dermatitis, eosinophilic granuloma, non-inflammatory alopecia, or ulcerative and crustacean dermatitis. Non-cutaneous clinical manifestations of this syndrome include sinusitis, feline asthma, and conjuctivitis. Intradermal Allergy and Ige ELISA tests are used to diagnose atopic syndrome. In the diagnosis of Feline atopic syndrome, it is important to eliminate causes such as food allergy or flea bite hypersensitivity. In addition, transepidermal water loss, which is one of the biophysical parameters, is widely used in diagnosis. Elimination of the cause, hypoallergenic diet, glucocorticoid, cyclosporine, oclakitinib, bronchodilator, antimicrobial and antihistamine applications are among the treatment options. Recently, the use of allergen-specific immunotherapy in controlling the clinical signs of allergic respiration and cutaneous diseases in atopic dermatitis has become widespread. Evaluation of the treatment options used in the disease according to individual differences is a point that should not be forgotten. This review article aims to emphasize the importance of feline atopic syndrome, which is becoming common in cats with allergic dermatitis.

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  • 1. Roberts ES, Speranza C, Friberg C, Griffin C, Roycroft L, et al. Confirmatory field study for the evaluation of ciclosporin at a target dose of 7,0 mg/kg (3,2 mg/lb) in the control of feline hypersensitivity dermatitides. Journal of Feline Medicine and Surgery 2016; 18: 889-897. doi: 10.1177/1098612X16636660.
  • 2. Paiva LMM, Pietroluongo B. Dermatite de hipersensibilidade não associada a pulgas e alimentos no paciente felino–relato de dois casos Non-Flea, Non-Food Hypersensitivity Dermatitis in the feline patient – two case report. Scientific Journal of Veterinary Medicine - Small Animals and Pets; Edition 48, 2018; 2: 26-32.
  • 3. Halliwell R, Banovic F, Mueller RS, Olivry T. Immunopathogenesis of the feline atopic syndrome. Veterinary Dermatology 2021; 32: 13-e4. doi: 10.1111/vde.12928.
  • 4. Colombo S. Feline Allergy. Feline Dermatology. April, 7-14, 2020; Birmingham-England.
  • 5. Ural K, Paşa S, Erdoğan H, Gültekin M, Ural DA, et al. House dust mite specific in vitro IgE determination in cats with allergic dermatitis. MAE Veteriner Fakültesi Dergisi 2019; 4: 14-17. doi: 10.24880/maeuvfd.526315.
  • 6. Bajwa J. Atopic dermatitis in cats. Canadian Veterinary Journal 2018; 59: 311–313.
  • 7. Foj R, Carrasco I, Clemente F, Scarampella F, Calvet A, et al. Clinical efficacy of sublingual allergen-specific immunotherapy in 22 cats with atopic dermatitis. Veterinary Dermatology 2021; 32: 67-e12. doi:10.1111/vde.12926.
  • 8. Halliwell R, Pucheu-Haston CM, Olivry T, Prost C, Jackson H, et al. Feline allergic diseases: introduction and proposed nomenclature. Veterinary Dermatology 2021; 32: 8-e2. doi:10.1111/vde.12899.
  • 9. Noli C, Matricoti I, Schievano C. A double-blinded, randomized, methylprednisolonecontrolled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfoodinduced hypersensitivity dermatitis. Veterinary Dermatology 2019; 30: 110-e30. doi:10.1111/vde.12720.
  • 10. Noli C, della Valle MF, Miolo A, Medori C, Schievano C, et al. Effect of dietary supplementation with ultramicronized palmitoylethanolamide in maintaining remission in cats with nonflea hypersensitivity dermatitis: a double-blind, multicentre, randomized, placebo-controlled study. Veterinary Dermatology 2019; 30: 387-e117. doi:10.1111/vde.12764.
  • 11. Ural K, Gül G, Gültekin M, Erdoğan S, Erdoğan H, ve ark. Baş boyun bölgesi dermatitli kedilerde korneometrik analizlerle deri hidrasyonunun ölçümü. MAE Veteriner Fakültesi Dergisi 2019; 4: 1-7. doi:10.24880/maeuvfd.521268.
  • 12. Flanagan S, Schick A, Lewis TP, Tater KC, Rishniw M. A survey of primary care practitioners’ referral habits and recommendations of allergen-specific immunotherapy for canine and feline patients with atopic dermatitis.Veterinary Dermatology 2021; 32: 106-e21. doi:10.1111/vde.12918.
  • 13. Marsella R, De Benedetto A. Atopic Dermatitis in Animals and People: An Update and Comparative Review. Veterinary Sciences 2017; 4: 37. doi: 10.3390/vetsci4030037.
  • 14. Fortson EA, Li B, Bhayana M. Introduction. Fortson EA, Feldman SR, Strowd LC. eds. In: Management of Atopic Dermatitis. Springer, 2017; pp. 1-11.
  • 15. Maina E, Fontaine J. Use of maropitant for the control of pruritus in non-flea, non-food induced feline hypersensitivity dermatitis: an open-label, uncontrolled pilot study. Journal of Feline Medicine and Surgery 2019; 21: 967–972.doi: 10.1177/1098612X18811372.
  • 16. Diesel A. Cutaneous Hypersensitivity Dermatoses in the Feline Patient: A Review of Allergic Skin Disease in Cats. Veterinary Sciences 2017; 4: 1-10. doi: 10.3390/vetsci4020025.
  • 17. Ravens PA, Xu BJ, Vogelnest LJ. Feline atopic dermatitis: a retrospective study of 45 cases (2001–2012). Veterinary Dermatology 2014; 25: 95-102 doi: 10.1111/vde.12109.
  • 18. Titeux E, Gilbert C, Briand A, Cochet-Faivre N. From Feline Idiopathic Ulcerative Dermatitis to Feline Behavioral Ulcerative Dermatitis: Grooming Repetitive Behaviors Indicators of Poor Welfare in Cats. Frontiers in Veterinary Science 2018; 5: 1-10. doi: 10.3389/fvets.2018.00081.
  • 19. Gedon NKY, Mueller RS. Atopic dermatitis in cats and dogs: a difcult disease for animals and owners. Clinical and Translational Allergy 2018; 8: 1-12.doi: 10.1186/s13601-018-0228-5.
  • 20. Jensen-Jarolim E, Herrmann I, Panakova L, Janda J. Allergic and Atopic Eczema in Humans and Their Animals. Jensen-Jarolim E. Eds. In: Comparative Medicine Disorders Linking Humans with Their Animals. Springer, 2017; pp. 131-150.
  • 21. Fuxench ZCC. Atopic Dermatitis: Disease Background and Risk Factors. Fortson EA, Feldman SR, Strowd LC. eds. In: Management of Atopic Dermatitis. Springer, 2017; pp. 11-19.
  • 22. Mueller RS, Nuttall T, Prost C, Schulz B, Bizikova P. Treatment of the feline atopic syndrome-a systematic review. Veterinary Dermatology 2021; 32: 43-e8. doi: 10.1111/vde.12933.
  • 23. Hufnagl K, Hirt R, Robibaro B. Out of Breath: Asthma in Humans and Their Animals. Jensen-Jarolim E. eds. In: Comparative Medicine Disorders Linking Humans with Their Animals. Springer, 2017; pp. 71-86.
  • 24. Santoro D, Pucheu-Haston CM, Prost C, Mueller RS, Jackson H. Clinical signs and diagnosis of feline atopic syndrome: detailed guidelines for a correct diagnosis. Veterinary Dermatology 2021; 32: 26-e6. doi: 10.1111/vde.12935.
  • 25. Fernandes KSBR, Ferreira MB, da silva AM, Marques KC, Rocha BZLL, et al. Efficacy of Oclacitinib on Feline Atopic Syndrome Management. Acta Scientiae Veterinariae 2019; 47: 374. doi:10.22456/1679-9216.89451. 26. Diesel A. Feline Atopic Syndrome: Epidemiology and Clinical Presentation. Noli C, Colombo S. eds. In: Feline Dermatology. Springer, 2020; pp. 451-464.
  • 27. Favrot C, Steffan J, Seewald W, Hobi S, Linek M, et al. Establishment of diagnostic criteria for feline nonflea-induced hypersensitivity dermatitis. Veterinary Dermatology 2012; 23: 45-50. doi:10.1111/j.1365-3164.2011.01006.x.
  • 28. Lesponne I, Boutigny L, Rochon J, Laxalde J, Langon X. Nutritionally-Based Improvement of Cats’ Skin & Coat Health, in Non-Flea, Non-FoodInduced Hypersensitive Dermatitis. BSAVA Congress. April, 448, 2020; Birmingham-United Kingdom.
  • 29. Gershwin LJ. Comparative Immunology of Allergic Responses. Annual Review of Animal Biosciences 2015; 3: 327-346. doi:10.1146/annurev-animal-022114-110930.
  • 30. Vogelnest DJ. Bacterial Diseases. Noli C, Colombo S. eds. In: Feline Dermatology. Springer, 2020; pp. 213-250.
  • 31. Szczepanik MP, Wilkolek PM, Adamek LR, Kalisz G, Golynski M, et al. Transepidermal water loss and skin hydration in healthy cats and cats with non-flea non-food hypersensitivity dermatitis (NFNFHD). Polish Journal of Veterinary Sciences 2019; 22: 237-242. doi:10.24425/pjvs.2019.127091.
  • 32. Day MJ. Cats are not small dogs: is there an immunological explanation for why cats are less affected by arthropod-borne disease than dogs?. Parasites & Vectors 2016; 9: 507. doi:10.1186/s13071-016-1798-5.
  • 33. Mazzei M, Vascellari M, Zanardello C, Melchiotti E, Vannini S, et al. Quantitative real time polymerase chain reaction (qRT-PCR) and RNAscope in situ hybridization (RNA-ISH) as effective tools to diagnose feline herpesvirus-1-associated dermatitis. Veterinary Dermatology 2019; 30: 491-e147. doi:10.1111/vde.12787.
  • 34. Noli C. Flea Biology, Allergy and Control. Noli C, Colombo S. eds. In: Feline Dermatology. Springer, 2020; pp. 437-450.
  • 35. De Bellis F. Latest Thinking on Atopic Dermatitis in Cats and Dogs. Vet Times 2014; April: 1-23.
  • 36. Noli C, Borio S, Varina A, Schievano C. Development and validation of a questionnaire to evaluate the Quality of Life of cats with skin disease and their owners, and its use in 185 cats with skin disease. Veterinary Dermatology 2016; 27: 247-e58. doi:10.1111/vde.12341.
  • 37. Noli C. Feline Atopic Syndrome: Theraphy. Noli C, Colombo S. eds. In: Feline Dermatology. Springer, 2020; pp. 475-488.
  • 38. Irwin K. Cyclosporine in Feline Dermatology. Little SE. eds.In: August's Consultations in Feline Internal Medicine. Elsevier, 2016; pp. 317-325.
  • 39. Dorofeeva Y, Shilovskiy I, Tulaeva I, Focke-Tejkl M, Flicker S, et al. Past, present, and future of allergen immunotherapy vaccines. Allergy 2021; 76: 131-149. doi: 10.1111/all.14300.
  • 40. Novakova P, Tiotiu A, Baiardini I, Krusheva B, Chong-Neto H, et al. Allergen immunotherapy in asthma: current evidence. Journal of Asthma 2021; 58: 223-230. doi:10.1080/02770903.2019.1684517.