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Background  Genetic and epidemiologic evidence suggests that in horses, as in other species, different manifestations of hypersensitivity may occur together.    Hypothesis  Horses affected with insect bite hypersensitivity ( IBH ) show airway hyperreactivity ( AH ) to inhaled histamine, even in the absence of overt clinical signs of equine asthma ( EA ).    Animals  Twenty‐two healthy controls (group C), 24 horses suffering from  IBH  alone (group  IBH ), and 23 horses suffering from  IBH  and  EA  (group  IBH / EA ).    Methods  The clinical histories were assessed using 2 standardized questionnaires, the Horse Owner Assessed Respiratory Signs Index ( HOARSI ), and  IBH  scoring. Horses were classified as  EA ‐affected if their  HOARSI  was >1 and as  IBH ‐affected if  IBH  score was >0. Confounding disorders were excluded by clinical examination. The arterial partial pressure of oxygen (PaO 2 ) was measured and flowmetric plethysmography used to assess airway reactivity to increasing doses of inhaled histamine.    Results  The median histamine provocation concentration ( PC ) when ∆ flow  values increased by 35% ( PC 35) was significantly higher in group C (5.94 [1.11–26.33] mg/mL) compared to group  IBH  (2.95 [0.23–10.13] mg/mL) and group  IBH / EA  (2.03 [0.43–10.94] mg/mL;  P  <   0.01). The  PC 50 and  PC 75 showed very similar differences between groups. Furthermore, PaO 2  was significantly lower in group  IBH  (84 ± 8 mmHg) and group  IBH / EA  (78 ± 11 mmHg) compared to group C (89 ± 6 mmHg;  P  <   0.01).    Conclusions and Clinical Importance   IBH  is associated with  AH  and decreased PaO 2 , even in the absence of overt respiratory clinical signs.

Insect Bite Hypersensitivity in Horses is Associated with Airway Hyperreactivity