Airway remodeling in horses with mild and moderate asthma.
Authors: Bessonnat Amandine, Hélie Pierre, Grimes Carolyn, Lavoie Jean-Pierre
Journal: Journal of veterinary internal medicine
Summary
# Airway Remodeling in Horses with Mild and Moderate Asthma Whilst airway remodeling is well-documented in equine severe asthma, evidence for similar structural changes in milder disease has been lacking until now. Bessonnat and colleagues conducted a retrospective case-control study comparing endobronchial biopsies from 12 horses with mild-to-moderate asthma (MMA) against 8 healthy controls, using detailed histomorphometry and semiquantitative scoring to quantify airway wall changes. Affected horses demonstrated significantly greater epithelial hyperplasia (47 versus 24 μm²/μm), lamina propria thickening (166 versus 76 μm), and smooth muscle fibrosis (42% versus 33%) compared to controls—changes previously thought exclusive to severe disease. Semi-quantitative analysis strengthened these findings: epithelial hyperplasia was evident in 7 of 12 MMA horses versus only 1 control, and submucosal inflammatory infiltrates were present in 11 of 12 affected horses. The evidence that progressive airway remodeling begins at milder stages of disease has significant implications for early intervention strategies; early diagnosis and aggressive management of MMA may help prevent or slow irreversible structural changes that contribute to clinical deterioration and reduced performance.
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Practical Takeaways
- •Airway remodeling occurs in horses with mild-moderate asthma, not just in severe cases, suggesting earlier intervention may be warranted
- •Endobronchial biopsy with histomorphometry can identify structural airway changes that support clinical diagnosis in horses with suspected asthma
- •Recognition of airway remodeling in milder disease stages may inform management strategies to prevent progression to severe asthma
Key Findings
- •Horses with mild-moderate asthma showed epithelial hyperplasia (47 μm²/μm vs 24 μm²/μm in controls; P=0.02)
- •Lamina propria thickness was significantly increased in asthmatic horses (166 μm vs 76 μm in controls; P=0.04)
- •Smooth muscle fibrosis was greater in mild-moderate asthma cases (42% vs 33% in controls; P=0.04)
- •Submucosal inflammatory leucocytes were present in 11 of 12 asthmatic horses compared to 4 of 8 control horses