Koloplet najčešćih imunosno posredovanih bolesti u pasa

Izv. prof. dr. sc. Mirna Brkljačić
Veterinarski fakultet Sveučilišta u Zagrebu Klinika za unutarnje bolesti

Izlaganje sa Znanstveno-stručnog skupa

VETERINARSKI DANI 2022.

Izvor: Zbornik radova Veterinarski dani, Poreč, 2022.
SažetakAbstract ▲

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Sažetak

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Imunosno posredovane bolesti predstavljaju skupinu bolesti koja je ujedno izazovna i frustrirajuća kako za dijagnostiku tako i za liječenje. Imunosno posredovana bolest nastaje u slučaju kada inače fiziološka obrana organizma od ”stranog” biva usmjerena na vlastito, a čemu prethodi stimulacija imunosnog sustava. Brojni su načini na koje imunosni sustav može biti stimuliran od kojih su neki dobro istraženi i razjašnjeni dok se o drugima tek raspravlja.

Naime, imunosno posredovane bolesti mogu biti idiopatske no češće postoji tzv. okidač razvoja imunosno posredovanog poremećaja u genetski predisponirane jedinke. Tako na primjer, spomenuti okidač može biti virus ili neki drugi mikroorganizam, lijek ili pak vakcina.

Upravo zbog navedenog, dijagnostički protokoli često su kompleksni i zahtjevni te primarno usmjereni prema otkrivanju bolesti koja leži u podlozi narušenog imunosnog odgovora. Imunosupresivni lijekovi koji su okosnica terapije često izazivaju brojne neželjene učinke i simptome od kojih su (ponekad) neki ozbiljniji od simptoma same bolesti.

Veterinarska klinička imunologija poglavito se oslanja na predloške iz humane medicine pa u zadnje vrijeme bilježi znatni porast broja bolesti u pasa za koje je sada potvrđeno da su zapravo uzrokovane (ili da između ostalog mogu biti uzrokovane) poremećajem imunosnih zbivanja.

Imunosno posredovana hemolitička anemija, imunosno posredovana trombocitopenija, imunosno posredovani poliartritis, nekrotizirajući meningoencefalitis, Vogt–Koyanagi–Harada-like sindrom, miastenija gravis, upalna bolest crijeva, analna furunkuloza, sistemski eritemski lupus, sebaceozni adenitis, Addisonova bolest i upalna bolest crijeva samo su neke od imunosno posredovanih bolesti pasa, a izgledno je da će se za brojne druge bolesti imunološka etiologija tek potvrditi. Također, većina lijekova i terapijskih protokola preuzeta je iz humane medicine bez provedenih prospektivnih placebo kontroliranih istraživanja na psima koja su nužna za standardiziranje lijekova izbora kod svake pojedine bolesti.
Ključne riječi: pas, imunosno posredovane bolesti, imunosno posredovana hemolitička anemija, imunosno posredovana trombocitopenija

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THE MAELSTROM OF THE MOST COMMON IMMUNE-MEDIATED DISEASES IN DOGS

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Mirna Brkljačić, PhD, Assistant Professor, Veterinary faculty University of Zagreb

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Immune-mediated diseases represent a group of diseases that are both challenging and frustrating both for diagnosis and treatment. Immune-mediated disease occurs when the physiological defence of the organism against the “foreign” is directed at its own, which is preceded by stimulation of the immune system. There are numerous ways in which the immune system can be stimulated, some of which are well researched and elucidated while others are still being discussed.
Therefore, immune-mediated diseases can be idiopathic, but more often there is a so-called trigger for the development of an immune-mediated disorder in genetically predisposed individual.
For example, the mentioned trigger can be a virus or some other microorganism, a drug or a vaccine. Therefore, diagnostic protocols are often complex and demanding and primarily aimed at detecting the underlying disease. Immunosuppressive drugs, which are the mainstream of treatment, often cause numerous side effects, some of which are (sometimes) more serious than the symptoms of the disease itself.

Veterinary clinical immunology mainly relies on models from human medicine, so recently it has recorded a significant increase in the number of canine diseases that have now been confirmed to be actually caused (or that, among other things, they can be caused) by disorders of the immune system. Immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, immune-mediated polyarthritis, necrotizing meningoencephalitis, Vogt–Koyanagi–Harada-like syndrome, myasthenia gravis, anal furunculosis, systemic lupus erythematosus, sebaceous adenitis, Addison’s disease, and inflammatory bowel disease are only some of the immune-mediated diseases of dogs, and it is likely that the immunological etiology of many other diseases is yet to be confirmed. Also, most of the drugs and therapeutic protocols were taken from human medicine without conducting prospective placebo-controlled studies on dogs, which are necessary for standardizing the drugs of choice for each individual disease.
Key words: dog, immune-mediated diseases, immune-mediated hemolytic anemia, immune-mediated thrombocytopenia