Towards personalized medicine for the treatment of equine asthma.
Authors: Leduc Laurence, Leclère Mathilde, Lavoie Jean-Pierre
Journal: Veterinary journal (London, England : 1997)
Summary
Equine asthma presents a significant clinical challenge because affected horses display markedly heterogeneous disease profiles—variations in severity, environmental triggers, inflammatory patterns, and underlying pathology—that have frustrated attempts to create discrete, biologically meaningful subgroups for targeted intervention. Leduc, Leclère, and Lavoie conducted a comprehensive review synthesising current knowledge of equine asthma phenotypes and endotypes, drawing parallels with precision medicine approaches already established in human respiratory disease to identify opportunities for personalised treatment strategies in horses. Their analysis reveals that phenotyping horses by clinical presentation, inflammatory markers, and pathological features could enable stratification of cases for condition-specific therapies rather than the current "one-size-fits-all" management approach. The implications for practitioners are substantial: implementing phenotype-based assessment protocols—incorporating airway endoscopy, bronchoalveolar lavage cytology, and potentially biomarkers—could facilitate targeted pharmaceutical or environmental interventions that improve outcomes compared to empirical treatment. This framework suggests productive research directions for equine veterinarians and allied professionals to establish evidence-based precision protocols that move beyond symptomatic management towards mechanistically informed, individualised care.
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Practical Takeaways
- •Individual horses with asthma require personalized assessment of their specific phenotype and triggers rather than uniform treatment protocols, as disease presentation varies significantly between affected animals.
- •Work with veterinarians to identify the underlying inflammatory profile and pathological features in each asthmatic horse to guide targeted therapy selection.
- •Expect emerging evidence-based precision medicine approaches in equine asthma management adapted from human respiratory medicine in coming years to improve treatment outcomes.
Key Findings
- •Equine asthma demonstrates significant heterogeneity in severity, triggering factors, inflammatory profiles, and pathological features despite similar clinical signs.
- •Recognition of distinct phenotypes and endotypes in equine asthma could enable development of precision medicine and personalized targeted therapies.
- •Knowledge from human medicine targeted therapy approaches can be translated to advance personalized medicine strategies in equine asthma treatment.