The Immune Mechanisms of Severe Equine Asthma-Current Understanding and What Is Missing

Simple Summary Severe equine asthma (sEA) is a highly prevalent respiratory disease affecting adult horses. Affected horses present with cough, nasal discharge and increased respiratory effort at rest. Although a complex diversity of genetic and immunological pathways contribute to the disease, these remain to be fully understood. Several studies have reported the role of inflammatory mediators and of some cells found in sEA airway inflammation. However, the reported results revealed some inconsistencies between studies. A better understanding of sEA's genetics and detailed immunology is fundamental in order to characterize the underlying mechanisms involved in the disease's occurrence and to establish an adequate therapy and a precise prognosis. This review examines some literature findings on the genetic and immunology of sEA and discusses further research areas. Severe equine asthma is a chronic respiratory disease of adult horses, occurring when genetically susceptible individuals are exposed to environmental aeroallergens. This results in airway inflammation, mucus accumulation and bronchial constriction. Although several studies aimed at evaluating the genetic and immune pathways associated with the disease, the results reported are inconsistent. Furthermore, the complexity and heterogeneity of this disease bears great similarity to what is described for human asthma. Currently available studies identified two chromosome regions (ECA13 and ECA15) and several genes associated with the disease. The inflammatory response appears to be mediated by T helper cells (Th1, Th2, Th17) and neutrophilic inflammation significantly contributes to the persistence of airway inflammatory status. This review evaluates the reported findings pertaining to the genetical and immunological background of severe equine asthma and reflects on their implications in the pathophysiology of the disease whilst discussing further areas of research interest aiming at advancing treatment and prognosis of affected individuals.