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Racehorse IAD – mild equine asthma?
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A clinical phenotype called inflammatory airway disease (IAD) is recognized as the second most common cause of poor performance in racehorses. The syndrome is characterized by chronic airway inflammation and is associated with mild clinical signs such as cough and excess tracheal mucus. Because IAD presents similarities with some subtypes of human asthma, the term “mild equine asthma” has been recently proposed1 .
Horses with mild asthma often present for decreased performance however, since many conditions can be implicated, non-respiratory causes must be ruled out. A diagnosis of mild asthma may be confirmed by endoscopy of the trachea post-racing to demonstrate excess mucus. A mucus accumulation score of 2 or higher (range 0-5) visualized approximately 1 hour post-racing has been associated with poor performance in both Standardbred and thoroughbred racehorses. Evidence of increased neutrophils, eosinophils or mast cells in bronchoalveolar lavage fluid (BALF) is also diagnostic of mild equine asthma. Eosinophils or mast cells are more commonly detected in young asthmatic racehorses whereas older racehorses are more often affected by neutrophilic asthma. Equine asthma in racehorses is also characterized by mild pulmonary dysfunction as evidenced by variable degree of airflow obstruction, airway hyperresponsiveness and impaired blood gas exchange during exercise2 .
There is mounting evidence that airway inflammation in racehorses is caused by exposure to dust although the role of infectious agents has not been ruled out definitively. In recent studies, we found associations between respirable dust exposure and airway eosinophilia in young thoroughbreds in training3 and airway neutrophilia in older racing Standardbreds (unpublished data). Taken together, clinical data associated with the IAD phenotype in racehorses support its inclusion in the equine asthma syndrome.
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