The Effect of Inhaled Ciclesonide Treatment on Systemic Markers of Immune Function in Horses

The use of dexamethasone to control equine asthma is a common and effective treatment. Although short-term systemic dexamethasone treatment has not been shown to induce systemic immunosuppression in the horse, the goal of this study was to determine whether inhaled ciclesonide, an FDA-approved drug for the treatment of equine asthma, exerts any systemic immunosuppressive effects when compared to dexamethasone-treated and untreated horses. Eighteen light, mixed breed horses, ranging in age from 3 to 8 years of age, were used for this study and randomly assigned to one of three treatment groups: (1) nontreated controls, (2) ciclesonide treatment, or (3) dexamethasone treatment. Blood was collected daily for steady-state messenger RNA (mRNA) analysis, as well as at Days 0, 5, 10, and 15 of treatment for in vitro stimulation with Concanavalin A (ConA). Messenger RNA relative quantities were determined using RT-qPCR for select genes. Two-way, repeated measures analysis of variance was used to analyze qPCR data and results considered significant at P < .05. There were significant decreases in the steady-state, whole-blood expression of granzyme B and interferon-γ due to dexamethasone treatment, when compared to the nontreated control group. Within ConA-stimulated samples, there remained a suppressive effect of dexamethasone treatment on granzyme B expression compared to nontreated control horses. Similar effects were not noted in the ciclesonide-treated horses. Significant effects of ciclesonide treatment on markers of immune function were not noted in this study, suggesting a low risk for immunosuppression with inhaled ciclesonide treatment.