Immunopathogenesis and immunotherapy of <i>Culicoides</i> hypersensitivity in horses: an update

Culicoides hypersensitivity (CH) is a strongly pruritic dermatitis of horses, characterised histologically by mixed perivascular to diffuse cellular infiltrates mononuclear cells and eosinophils, caused helper T cell (Th)2, immunoglobulin (Ig)E‐mediated reactions antigens present in the saliva biting midges. As treatment CH still not satisfactory, better knowledge pathogenesis needed for development new therapeutic modalities. Accordingly, availability pure allergens instead crude whole body extracts essential improvement vitro diagnosis more effective allergen immunotherapy (AIT). Beside Th2 cytokines interleukin (IL)‐4 IL‐13, recent studies have shown involvement thymic stromal lymphopoietin, IL‐5 IL‐31 CH. The importance has been confirmed through targeting these active immunisation patients, resulting significant decrease lesion scores. Thirty salivary described over last 10 years produced as recombinant (r‐) proteins. Use protein microarray allowed identification most relevant r‐allergens central northern Europe. An protocol developed preventive AIT against Small amounts r‐ injected into submandibular lymph nodes with Alum/MPLA adjuvants seem induce suitable immune response both AIT. next will reveal whether advancements translate an improved diagnosis, prevention