title: Clinical evaluation of a nutraceutical diet as an adjuvant to pharmacological treatment in dogs affected by Keratoconjunctivitis sicca.
abstract: BACKGROUND
  Canine keratoconjunctivitis sicca (cKCS) is an inflammatory eye condition related to a deficiency in the tear aqueous fraction. Etiopathogenesis of such disease is substantially multifactorial, combining the individual genetic background with environmental factors that contribute to the process of immunological tolerance disruption and, as a consequence, to the emergence of autoimmunity disease. In this occurrence, it is of relevance the role of the physiological immune-dysregulation that results in immune-mediated processes at the basis of cKCS. Current therapies for this ocular disease rely on immunosuppressive treatments. Clinical response to treatment frequently varies from poor to good, depending on the clinical-pathological status of eyes at diagnosis and on individual response to therapy. In the light of the variability of clinical response to therapies, we evaluated the use of an anti-inflammatory/antioxidant nutraceutical diet with potential immune-modulating activity as a therapeutical adjuvant in cKCS pharmacological treatment. Such combination was administered to a cohort of dogs affected by cKCS in which the only immunosuppressive treatment resulted poorly responsive or ineffective in controlling the ocular symptoms.
  
  
  RESULTS
  Fifty dogs of different breeds affected by immune-mediated cKCS were equally distributed and randomly assigned to receive either a standard diet (control, n = 25) or the nutraceutical diet (treatment group, n = 25) both combined with standard immunosuppressive therapy over a 60 days period. An overall significant improvement of all clinical parameters (tear production, conjunctival inflammation, corneal keratinization, corneal pigment density and mucus discharge) and the lack of food-related adverse reactions were observed in the treatment group (p < 0.0001).
  
  
  CONCLUSIONS
  Our results showed that the association of traditional immune-suppressive therapy with the antioxidant/anti-inflammatory properties of the nutraceutical diet resulted in a significant amelioration of clinical signs and symptoms in cKCS. The beneficial effects, likely due to the presence of supplemented nutraceuticals in the diet, appeared to specifically reduce the immune-mediated ocular symptoms in those cKCS-affected dogs that were poorly responsive or unresponsive to classical immunosuppressive drugs. These data suggest that metabolic changes could affect the immune response orchestration in a model of immune-mediated ocular disease, as represented by cKCS.
authors.affiliation: Clinica Veterinaria Porta Venezia, via Lambro 12, 20121, Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Destefanis
authors.affiliation: Clinica Veterinaria Cartesio, viale Olanda 3B, Melzo, 20066, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Giretto
authors.affiliation: Ambulatorio Veterinario Canonica, via Canonica 36, 20154, Milan, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Muscolo
authors.affiliation: School of Specialization in Clinical Biochemistry, "G. d'Annunzio" University, Chieti, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Cerbo
authors.affiliation: Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy.
authors.forename: Gianandrea
authors.initials: G
authors.lastname: Guidetti
authors.affiliation: Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Canello
authors.affiliation: Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Giovazzino
authors.affiliation: Research and Development Department, SANYpet S.p.a., Bagnoli di Sopra, Padua, Italy. sarac@forza10.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Centenaro
authors.affiliation: Department of Science, University of Basilicata, Via Sauro, 85, 85100, Potenza, Italy.|Department of Translational Medical Sciences, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Terrazzano
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000818:Animals; D003228:Conjunctiva / Q000473:pathology; D004032:Diet / Q000662:veterinary*; D019587:Dietary Supplements; D004283:Dog Diseases / Q000188:drug therapy / Q000628:therapy*; D004285:Dogs; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007638:Keratoconjunctivitis Sicca / Q000188:drug therapy / Q000628:therapy / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D007166:Immunosuppressive Agents
keywords: Antioxidant and anti-inflammatory diet; Immune-mediated ocular disease; Keratoconjunctivitis sicca; Nutraceutical diet