Equine Hypersensitivity: the Dark Horse of Allergy
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Equine Hypersensitivity: the Dark Horse of Allergy Julie Davenport 1
&
Derek Smith 1
# This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020
Abstract A significant amount of medical literature has been published on the prevalence and treatment modalities of allergies to common household pets like dogs and cats. Although sensitization rates to horses are high in many urban areas, allergies to horses are rarely discussed. In order for allergists to treat effectively horse-allergic patients, they must be aware of various clinical presentations and treatment modalities that exist. A literature search was conducted in PubMED using the terms horse, immunotherapy, inhalant allergies, and food allergy limited to human studies from any period. What follows is a review of the prevalence, clinical presentations, and treatment modalities of horse aeroallergens and food allergies. Keywords Equine hypersensitivity . Prevalence . Horse aeroallergens . Clinical presentations . Food allergies
Introduction The association between humankind and the horse has been intertwined since before the dawn of recorded history. Evidence from archeology and cave paintings shows that humans have hunted horses for food for over 10,000 years, and probably herded horses for beasts of burden for over 5000 years. Throughout history, this relationship has continued, as seen in the technology that revolutionized warfare: the bit, stirrup, saddles, and chariots, as well as in transportation and agriculture. The horse has influenced human culture, and humans, through selective breeding, have, in turn, influenced the horse, creating Shetland ponies, as well as great draft breeds, which trace their lineage back to the knights and the crusades [1–4]. With the almost complete mechanization of agriculture, transportation, and warfare, the role of the horse has evolved. Yet, the horse still exerts a prominent role in human culture. As humans and horses continue to come into contact with one another, allergic reactions to horses remain a significant field of study. What follows is a review of the prevalence, clinical
* Julie Davenport [email protected] Derek Smith [email protected] 1
Allergy-Immunology Clinic, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, TX, USA
presentations, and treatment modalities of horse aeroallergens and food allergies.
Prevalence of Sensitization It is not unexpected that allergy to horses occurs largely among those who interact with them regularly either through occupational or recreational pursuits. In 2002, a crosssectional study revealed a 12.8% sensitization rate to horse hair among 125 grooms, as compared with 4.3% in the general population. These grooms also had significantly higher rates of asthma, allergic rhinoconjuctivitis, and allergic skin disease, when compared with the general population without direct exposure to horses [5]. Another cross-sectional study, which included 42 Iranian horse
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