Presentazione Allergia_23Mag13
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Transcript of Presentazione Allergia_23Mag13
14th June 2013
MANAGEMENT OFALLERGIC DISEASE
IN COMPANIONANIMALS
Dr. Brusati Dr. Tambone
ALLERGY MANAGEMENT
ALLERGY TESTING AND TREATMENTS
. AGROLABO has been involved in Allergy management for more than 20 years, offering to vets:
HIGHLY SPECIFIC INTRADERMAL TEST KITS
TECHNICALLY-ADVANCED IN-VITRO SERUM TESTING SERVICES
PERSONALISED PATIENT-SPECIFIC IMMUNOTHERAPY TREATMENTS
ALLERGY TESTING
.
• ALLERGY TESTS MUST NOT TO BE CONSIDERED AS DIAGNOSTIC TESTS FOR ATOPY
• DIAGNOSIS HAS TO BASED ON THE COMBINATION OF DIFFERENT PARAMETERS: PATIENT HISTORY, CLINICAL SIGNS AND DIFFERENTIAL DIAGNOSES
PRINCIPAL METHODS
INTRADERMAL TESTING ELISA TESTING
ALLERGY TESTING
.
THE REAL UTILITY OF ALLERGY TESTS IS TO IDENTIFYAND SELECT THE ALLERGENS TO WHICH THE ANIMAL IS SENTISITVE
AND PREPARE THE PERSONALISED IMMUNOTHERAPY
PRINCIPAL METHODS
INTRADERMAL TESTING ELISA TESTING
ALLERGY TESTING
.
“NO METHOD HAS BEEN CONCLUSIVELY SHOWN TO BE THE BEST, HOWEVER PERFORMING BOTH TESTS GIVES THE BEST INFORMATION
ON THE PATIENT’S SENSITIVITY”
(DEBOER, 2012)
PRINCIPAL METHODS
INTRADERMAL TESTING ELISA TESTING
INTRADERMAL TESTING
.
INTRADERMAL TESTING DETECTS NOT ONLY THE PRESENCE OF SPECIFIC IgE ANTIBODIES,
BUT ALSO THE FUNCTIONAL ABILITY FOR CUTANEOUS MAST CELLS TO DEGRANULATE UPON EXPOSURE TO ALLERGEN EXTRACTS
INTRADERMAL TESTING
.
INTRADERMAL TESTING
is the method of choice for many specialists and is
particularly appreciated because it is
relatively free from false positive
reactions (high specifity)
• Allergen quality, dilution and storage are
key factors
• Corticosteroids adversely affect
reactivity of the skin and it is necessary to discontinue the
administration for weeks
• The majority of dermatologists prefer to use sedation for testing
• The animal must be shaved
• No standardized criteria are used for
interpretation of reactions
HOWEVER
AGROLABO AGROSKIN TEST KITS
DIFFERENT KITS ARE AVAILABLE:
Agroskin RTU 20 =diluted allergens to perform
20 SKIN TESTS
Agroskin CT 100 or Agroskin CT 200 = concentrated allergen extracts to
perform 100 or 200 SKIN TESTS
IN-VIVO TESTS TO IDENTIFY SPECIFIC ALLERGENS IN CATS, DOGS AND HORSES
AGROLABO AGROSKIN TEST KITS
AGROSKIN RTU 20, AGROSKIN CT 100, AGROSKIN CT 200:
• TAILOR-MADE KITS WITH PERSONALISED SELECTION OF ALLERGEN EXTRACTS
• KITS MANUFACTURED UPON REQUEST IN ORDER TO GUARANTEE MAXIMUM SHELF-LIFE
• HIGHLY SPECIFIC AND RELIABLE RESULTS
• COST EFFECTIVE
ALLERGENS AVAILABLE FOR AGROSKIN TEST KITS
GRASS POLLEN WEED POLLEN TREE POLLEN
ANTHOXANTUM ODORATUM(SWEET VERNAL)
AMBROSIA MIX (RAGWEED SP.) ACER SPP. (MAPLE)
CYNODON DACTYLON (BERMUDA GRASS)
ARTEMISIA VULGARIS (COMMON MUGWORT)
ALNUS SPP. (ALDER)
DACTYLIS GLOMERATA (ORCHARD GRASS)
CHENOPODIUM ALBUM (LAMB'S QUARTER)
BETULA SPP. (BIRCH)
FESTUCA ELATIOR (MEADOW FESCUE)
PLANTAGO LANCEOLATA (ENGLISH PLANTAIN)
CORYLUS SPP. (HAZEL)
HOLCUS LANATUS (VELVET) RUMEX ACETOSELLA (SHEEP SORREL)
FAGUS SPP. (BEECH)
LOLIUM PERENNE (PERENNIAL RYEGRASS)
TARAXACUM OFFICINALE DANDELION)
FRAXINUS SPP. (ASH)
PHLEUM PRATENSE (TIMOTHY GRASS)
URTICA DIOICA (STINGING NETTLE) OLEA EUROPEA (OLIVE)
POA PRATENSIS (KENTUCKY BLUE GRASS)
PLATANUS OCCIDENTALIS(WESTERN CAMORE)
SECALE CEREALE (CULTIVATED RYE)
POPULUS NIGRA (BLACK POPULAR) QUERCUS SPP. (OAK) SALIX SPP. (WILLOW)
ALLERGENS AVAILABLE FOR AGROSKIN TEST KITS
MITES FUNGI AND YEAST OTHERS
ACARUS SIRO (FLOUR MITE) ALTERNARIA ALTERNATA (FUNGUS)
CAT EPITHELIA
DERMATOPHAGOIDES FARINAE (DUST MITE)
ASPERGILLUS SPP. (FUNGUS)
CLADOSPORIDIUM HERBRUM (FUNGUS)
FEATHER MIX
HUMAN DANDER
DERMATOPHAGOIDES PTERONYSSINUS (DUST MITE)
MALASSEZIA PACHIDERMATIS (YEAST)
LEPIDOGLYPHUS DESTRUCTOR (FORAGE MITE)
PENICILLIUM NOTATUM (MOULD)
TYROPHAGUS PUTRESCENTIAE (FOOD MITE)
FEATHER
SEROLOGICAL TESTING ELISA SEROLOGY TEST METHODS
• If steroid or anti-histamine treatments are not prolonged and not at high dosages, they do not need to
be suspended
• No shaving or sedation required
• Ideal for patients with unhealthy skin
• Not standardised results are
offered
• The quality of detection
reagents is a key factor (detection
of only IgE antibodies and not IgG or IgM)
THE ELISA SEROLOGY TEST METHOD MEASURES THE AMOUNT OF ALLERGEN
SPECIFIC IgE ANTIBODIES IN SERUM SAMPLES
HOWEVER
IgE DETECTION ANTIBODY(CONJUGATE)
POLYCLONAL ANTIBODY CROSS-REACTS EXTENSIVELY WITH IgG: LOW SPECIFICITY, HIGH SENSITIVITY
MONOCLONAL ANTIBODY DOES NOT CROSS-REACT WITH IgG: HIGH SPECIFICITY, LOWER SENSITIVITY
HUMAN HIGH-AFFINITY IgE RECEPTOR UNIQUE BINDING SITE FOR THE FRAGMENT Fc OF IgE:HIGH SPECIFICITY, LOWER SENSITIVITY
GREER mac (Monoclonal Antibodies Cocktail) ELISA
Allergen Solid Phase
IgE
GREER mac (Monoclonal Antibodies Cocktail) ELISA
B B
BB
BB
B
B
B
Allergen Solid Phase
Anti-IgE Biotin
IgE Fragment FC
AGROLABO SEROLOGICAL TESTING
AGROLABO OFFERS AN IgE ALLERGEN-SPECIFIC TEST, WHICH ALLOWS FOR THE DETECTION OF
ALLERGEN SPECIFIC IgE LEVELS TO INDIVIDUAL ALLERGENS
• WIDE RANGE OF ALLERGENS IN DIFFERENT PANELS
• EACH PANEL CONTAINS FROM 6 TO 18 INDIVIDUAL ALLERGENS, WHICH ARE SPECIFIC FOR CATS, DOGS AND HORSES
• VERY VALUABLE TOOL TO DETERMINE WHICH ALLERGENS SHOULD BE INCLUDED IN the ALLERGEN-SPECIFIC IMMUNOTHERAPY TREATMENT
• SEMI-QUANTITATIVE RESULTS expressed as Elisa Allergy Units
AGROLABO mac ELISA SEROLOGICAL PANELS
ALLERGEN-SPECIFIC IgE TESTING FOR DOGS AND CATSPRESCREENING PANELSEASONAL (POLLEN) PANELPERENNIAL (INDOOR) PANELFOOD PANEL
ALLERGEN-SPECIFIC IgE TESTING FOR HORSES
PRESCREENING PANELSEASONAL (POLLEN) PANELPERENNIAL (INDOOR) PANEL FOOD PANEL
PRESCREENING PANEL ALLERGEN GROUPS
POLLEN WELL FUNGI WELL FLEA WELL MITE WELL
AMBROSIA MIX, BETULA SP., CYNODON DACTYLON, LOLIUM PERENNE, OLEA AEUROPEA, PLANTAGO LANCEOLATA, PARIETARIA OFFICINALIS, POA PRATENSIS, QUERCUS SPP.
ALTERNARIA ALTERNATA, ASPERGILLUS SP., CLADOSPORIUM HERBARUM, PENICILLIUM NOTATUM
CTENOCEPHALIDES FELIS, CTENOCEPHALIDES CANIS
ACARUS SIRO, DERMATOPHAGOIDES FARINAE, DERMATOPHAGOIDES PTERONYSSINUS, TYROPHAGUS PUTRESCENTIAE
SPECIFIC ALLERGEN PANEL FOR CATS AND DOGS
SEASONAL (POLLEN) PANEL
GRASSES WEEDS TREES
POA PRATENSIS, DACTYLIS GLOMERATA, LOLIUM PERENNE, FESTUCA ELATIOR(MIX 1 GRASSES)
ARTEMISIA VULGARIS (COMMON MUGWORT)
CUPRESSUS SEMPERVIRENS. (CYPRESS)
BROMUS INERMIS, CYNODON DACTILON (MIX 2 GRASSES)
CHENOPODIUM ALBUM (LAMB'S QUARTER)
BETULA PENDULA (BIRCH)
MIX AMBROSIA (RAGWEED) OLEA EUROPEA (OLIVE)
PARIETARIA OFFICINALIS (PELLITTORY)
POPULUS MIX (POPLAR)
PLANTAGO LANCEOLATA (ENGLISH PLANTAIN)
QUERCUS SP. (OAK)
SPECIFIC ALLERGEN PANELS FOR CATS AND DOGS
PERENNIAL (INDOOR) PANEL
MITES FUNGI / YEAST FLEAS FOOD
ACARUS SIRO (FLOUR MITE) ALTERNARIA ALTERNATA (FUNGI)
CTENOCEPHALIDES FELIS, CANIS (FLEA)
BEEF, CHICKEN, AND TURKEY, DUCK LAMB, RABBIT
DERMATOPHAGOIDES FARINAE (DUST MITE)
ASPERGILLUS FUMIGATUS (FUNGI)
FISH MIX
DERMATOPHAGOIDES PTERONYSSINUS (DUST MITE)
CLADOSPORIUM HERBARUM (MOULD)
EGGS
GLYCIPHAGUS DOMESTICUS (GRAIN MITE)
MALASSEZIA PACHIDERMATIS(YEAST)
MILK
LEPIDOGLYPHUS DESTRUCTOR (FORAGE MITE)
PENICILIUM NOTATUM (MOULD)
CORN AND WHEAT
TYROPHAGUS PUTRESCENTIAE (FOOD MITE)
POTATO, SOYABEAN
RICE
FOOD PANEL
SPECIFIC ALLERGEN PANEL FOR HORSES
GRASSES WEEDS TREES
POA PRATENSIS, DACTYLIS GLOMERATA, LOLIUM PERENNE, FESTUCA ELATIOR(MIX 1 GRASSES)
ARTEMISIA VULGARIS (COMMON MUGWORT)
CUPRESSUS SEMPERVIRENS (CYPRESS)
BROMUS INERMIS, CYNODON DACTILON (MIX 2 GRASSES)
BRASSICA NAPUS (RAPE) BETULA PENDULA (BIRCH)
PHLEUM PRATENSE (GRASS) CHENOPODIUM ALBUM (LAMB’S QUARTER)
FAGUS SP. (BEECH)
TRITICUM, AVENA, ZEA MAYS, HORDEUM, SECALE (CEREAL)
PARIETARIA OFFICINALIS (PELLITTORY)
POPULUS MIX (POPLAR)
PLANTAGO LANCEOLATA (ENGLISH PLANTAIN)
FRAXINUS SP. (ASH)
RUMEX ACETOSELLA (SHEEP SORREL)
SALIX SP. (WILLOW)
OLEA EUROPEA (OLIVE)
SEASONAL PANEL
SPECIFIC ALLERGEN PANELS FOR HORSES
MITESFUNGI / YEAST
INSECTS FOOD
ACARUS SIRO (FLOUR MITE) ALTERNARIA ALTERNATA (FUNGI)
CHRYSOPS SP. (DEER FLY)
MILK
DERMATOPHAGOIDES FARINAE (DUST MITE)
ASPERGILLUS FUMIGATUS (FUNGI)
CULEX (MOSQUITO) SOYABEAN
DERMATOPHAGOIDES PTERONYSSINUS (DUST MITE)
USTILAGO SP. (FUNGI)
TABANUS (HORSE FLY) CORN, BARLEY, OAT
GLYCIPHAGUS DOMESTICUS (GRAIN MITE)
RHIZOPUS NIGRICANS (FUNGI)
CULICOIDES (MIDGE) WHEAT
LEPIDOGLYPHUS DESTRUCTOR (FORAGE MITE)
CLADOSPORIUM HERBARUM (MOULD)
BLATELLA GERMANICA (GERMAN COCKROACH)
APPLE
TYROPHAGUS PUTRESCENTIAE (FOOD MITE)
PENICILIUM NOTATUM (MOULD)
MUSCA DOMESTICA (HOUSE FLY)
MOLASSA
ALFAALFA
CARROTS, POTATO
MALT
PERENNIAL (INDOOR) PANEL FOOD PANEL
COMPARISON BETWEEN INTRADERMAL AND ELISA
TECHNIQUE
INTRADERMAL TESTING
• Invasive system (shaving and sedation can be required)
• It cannot be performed in the case of skin diseases
• Personalised selection of the allergens
• Suspension of the corticosteroid and/or antihistamine treatments for a long period
• Possibility of anaphylactic shock
ELISA TESTING
• Simple blood sample
•Simple blood sample
• Preset panels
•Suspension of corticosteroid and/or antihistamine treatments is not required
• No possibility
HOW CAN I REQUEST TESTING SERVICES FOR CATS, DOGS AND
HORSES?
• FILL IN THE TESTING ORDER FORM AND THE ANAMNESTIC FORM
• COLLECT THE SERUM SAMPLE
• LABEL THE TEST TUBE
• PLACE THE COLLECTION TUBE, TOGETHER WITH THE ANAMNESTIC and the ORDER FORMS, IN THESHIPPING ENVELOPE
• SUBMIT TO AGROLABO
FAST AND QUALITY TESTING SERVICES
• AGROLABO PROVIDES FOC: - VIALS FOR COLLECTING THE SAMPLE- ENVELOPE FOR SHIPPING THE SAMPLE
• TEST RESULTS ARE AVAILABLE WITHIN 48 HOURSOF RECEIVING SAMPLE BY FAX, EMAIL OR POST
• THE RECORD OF EACH PATIENT ARE FILED IN THE COMPUTER
• AGROLABO OFFERS TECHNICAL ASSISTANCEAND COMMERCIAL ADVICE
ALLERGEN-SPECIFIC IMMUNOTHERAPY TREATMENT
”THE ONLY TREATMENT THAT CAN DIRECTLY REVERSE PART OF THE PATHOGENESIS OF THE DISEASE”
(DJ. DEBOER 2012)
ALLERGEN-SPECIFIC IMMUNOTHERAPY TREATMENT
Accurate testing is important to identify the offending allergens.
Once they have been identified they are included in the IMMUNOTHERAPY.
The IMMUNOTHERAPY TREATMENT is based on the subcutaneous injection of a gradually increasing amount of the allergen extracts to which the patient
is sensitive
ALLERGEN-SPECIFIC IMMUNOTHERAPY TREATMENTS
•Specific formulated immunotherapy treatment sets for cats, dogs, and horses (it is advisable to include no more than 10 allergens)
•Each treatment set contains between 1 and 4 vials of immunotherapy treatment solution depending on weight, number of allergens, administration timing
•Vials for cats contain 5ml of solution; vials for dogs and horses are prepared with a 9ml volume of solution
•An individual dosage schedule for each patient is included with each treatment set
ALLERGEN-SPECIFIC IMMUNOTHERAPY TREATMENTS
•Side effects include localized itch at the injection site and transient worsening of symptoms duringthe first days of treatment
•Response to immunotherapy is 60 - 75%
good toexcellent in 6 -12 months of treatment
•Allergen-specific immunotherapy is considered to be lifelong.It takes several monthsor more to see the response and nearlyno adverse effect occurs in the greatmajority of animals
MARKETING MATERIALS AND SUPPLIES
PATIENT HISTORY AND ORDER FORMS
AGROLABO PROVIDES AN ASSORTMENT OF FREE MARKETING MATERIALS AND SALES SUPPORT TO ASSIST IN PROMOTING ALLERGY MANAGEMENT IN THE
PRACTICE
FULL-COLOUR POSTER
LEAFLETS FOR VETS AND PET OWNERS
SPECIMEN SHIPMENT KIT
WHY SHOUD YOU USE AGROLABO?
COMPLETE SOLUTIONS
FAST SERVICE
ACCURACY OF TESTING
PERSONALIZED IMMUNOTHERAPY
CONSULTINGALWAYS AVAILABLE
LOW PRICES
THANK YOU!
THANK YOU FOR YOUR ATTENTION