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


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

.

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)


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)


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


ASPERGILLUS FUMIGATUS (FUNGI)

FISH MIX


CLADOSPORIUM HERBARUM (MOULD)

EGGS

GLYCIPHAGUS DOMESTICUS (GRAIN MITE)

MALASSEZIA PACHIDERMATIS(YEAST)

MILK


PENICILIUM NOTATUM (MOULD)

CORN AND WHEAT


POTATO, SOYABEAN

RICE

FOOD PANEL

SPECIFIC ALLERGEN PANEL FOR HORSES

GRASSES WEEDS TREES

POA PRATENSIS, DACTYLIS GLOMERATA, LOLIUM PERENNE, FESTUCA ELATIOR(MIX 1 GRASSES)


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)


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


ASPERGILLUS FUMIGATUS (FUNGI)

CULEX (MOSQUITO) SOYABEAN


USTILAGO SP. (FUNGI)

TABANUS (HORSE FLY) CORN, BARLEY, OAT

GLYCIPHAGUS DOMESTICUS (GRAIN MITE)

RHIZOPUS NIGRICANS (FUNGI)

CULICOIDES (MIDGE) WHEAT


CLADOSPORIUM HERBARUM (MOULD)

BLATELLA GERMANICA (GERMAN COCKROACH)

APPLE


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

Presentazione Allergia_23Mag13

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