Atopik Dermatitli Köpeklerde Kaşıntı Giderici Tedavi Yöntemi Olarak Nebülize Metilen Mavisi

Yıl 2025, Cilt: 6 Sayı: 1, 41 - 45, 30.06.2025

Kerem Ural , Hasan Erdoğan , Songül Erdoğan , Serdar Paşa , Alper Sungur , Tahir Özalp

https://doi.org/10.58833/bozokvetsci.1704617

Öz

Köpeklerde atopik dermatit (cAD), başlıca belirti olarak pruritus (kaşıntı) ile seyreden kronik bir inflamatuvar deri hastalığıdır. Geleneksel tedavi yöntemleri arasında topikal ve sistemik ajanların yanı sıra alerjene özgü immünoterapi (ASIT) yer almaktadır; ancak bu yöntemlerin etkinliği değişkenlik göstermekte ve olası yan etkileri nedeniyle alternatif tedavi yaklaşımlarına ihtiyaç duyulmaktadır. Metilen mavisi (MB), antimikrobiyal ve nöromodülatör etkileri bulunan katyonik bir fotosensitizer olup, insan tıbbında periferik sinir uçlarını bloke ederek pruritusun hafifletilmesinde olumlu sonuçlar göstermiştir. Bu çalışmanın amacı, nebulizasyon yoluyla uygulanan MB’nin atopik dermatitli köpeklerde kaşıntı şiddetini azaltmadaki tedavi edici potansiyelini değerlendirmektir. Bu amaçla, en az üç haftadır herhangi bir tedavi almamış ve atopik dermatit tanısı konmuş toplam 13 köpek çalışmaya dahil edilmiştir. Tüm olgular, Köpek Atopik Dermatiti Yaygınlık ve Şiddet İndeksi (CADESI-04) ve Görsel Analog Skala (VAS) kullanılarak değerlendirilmiştir. MB, tek seanslık bir nebulizasyon uygulamasıyla verilmiş ve pruritus skorları 2., 4., 6., 8. ve 10. günlerde kaydedilmiştir. Elde edilen veriler, MB uygulamasını takiben kaşıntı skorlarında belirgin bir azalma olduğunu göstermiştir; en dikkat çekici iyileşmeler ise 4., 6. ve 8. günlerde gözlenmiştir. Çalışma süresince herhangi bir yan etkiye rastlanmamıştır. Nöromodülatör ve antiinflamatuvar özellikleri göz önünde bulundurulduğunda, MB, atopik dermatitle ilişkili pruritusun kontrolünde umut vadeden bir alternatif tedavi seçeneği olarak öne çıkmaktadır. Sonuç olarak, nebulize MB uygulaması, cAD olgularında pruritusun yönetiminde güvenli ve etkili bir yöntemdir. Bu bulgular, veteriner dermatoloji alanında MB’nin etki mekanizmalarının ve uzun vadeli tedavi potansiyelinin daha kapsamlı şekilde araştırılmasını gerektirmektedir.

Anahtar Kelimeler

Metilen mavisi , köpeklerde atopik dermatit , kaşıntı , nebülizasyon , veteriner dermatoloji

NEBULIZED METHYLENE BLUE AS AN ANTI-PRURITIC TREATMENT MODALITY IN DOGS WITH ATOPIC DERMATITIS

Öz

Canine atopic dermatitis (cAD) is a chronic inflammatory dermotological disorder in dogs, primarily characterized by pruritus. Conventional treatment modalities involve topical and systemic agents among allergen-specific immunotherapy (ASIT); however, their effectiveness varies, and potential adverse effects necessitate alternative therapeutic approaches. Methylene blue (MB) is a cationic photosensitizer with antimicrobial and neuromodulatory effects, previously shown to alleviate pruritus in human medicine by blocking peripheral nerve endings. This study aimed to evaluate the therapeutic capability of nebulized MB in reducing pruritus severity in dogs with AD. For this propose a total of 13 dogs diagnosed with AD without any treatment for at least three weeks were enrolled to the study. All cases were assessed using the Canine Atopic Dermatitis Extent and Severity Index (CADESI-04) and Visual Analog Scale (VAS). MB was administered via nebulization in a single session, and pruritus scores were recorded on days 2, 4, 6, 8, and 10. The results demonstrated a marked reduction in pruritus scores following MB administration, with the most significant improvements observed on days 4, 6, and 8. no adverse effects were noted throughout the study. Given its neuro-modulatory and anti-inflammatory properties, MB appears to be a promising alternative approach for the management of pruritus associated with AD in dogs. In conclusion nebulized MB is a safe and effective treatment modality for pruritus management in cAD. These findings warrant further controlled studies to elucidate the underlying mechanisms and long-term therapeutic potential of MB in veterinary dermatology.

Anahtar Kelimeler

Methylene blue , canine atopic dermatitis , pruritus , nebulization , veterinary dermatology

Kaynakça

• 1. Olivry, T., DeBoer, D. J., Favrot, C., Jackson, H. A., Mueller, R. et al. Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA). BMC Vet Res. 2015; 11: 210.
• 2. Gonzales, A. J., Bowman, J. W., Fici, G. J., Zhang, M., Mann, D, et al. Oclacitinib (APOQUEL®) is a novel Janus kinase inhibitor with activity against cytokines involved in allergy. J Vet Pharmacol Ther. 2014; 37(4): 317–324.
• 3. Mueller R. Allergen-specific immunotherapy. In: Noli C, Foster A, Rosenkrantz W, eds. Veterinary Allergy. Oxford: John Wiley & Sons; 2014: 85–89.
• 4. Kaur, G., Ramirez, A., Xie, C., Clark, D., Dong, C., Maki, C. et al. A double-blinded placebo-controlled evaluation of adipose-derived mesenchymal stem cells in treatment of canine atopic dermatitis. Vet Res Commun. 2022; 46(1): 251–260.
• 5. Bachmann, M. F., Zeltins, A., Kalnins, G., Balke, I., Fischer, N, et al. Vaccination against IL-31 for the treatment of atopic dermatitis in dogs. J Allergy Clin Immunol. 2018; 142(1): 279–281.
• 6. Biasibetti E, Bruni N, Bigliati M, Capucchio MT. Lactoferricin/verbascoside topical emulsion: A possible alternative treatment for atopic dermatitis in dogs. Nat Prod Res. 2018; 32(17): 2107–2110.
• 7. Loewinger, M., Wakshlag, J. J., Bowden, D., Peters‐Kennedy, J., & Rosenberg, A. The effect of a mixed cannabidiol and cannabidiolic acid-based oil on client‐owned dogs with atopic dermatitis. Vet Dermatol. 2022; 33(4): 329–e77. 8. Klinger, C. J., Hobi, S., Johansen, C., Koch, H. J., Weber, K, et al. Vitamin D shows in vivo efficacy in a placebo-controlled, double-blinded, randomised clinical trial on canine atopic dermatitis. Vet Rec. 2018; 182(14): 406–406.
• 9. Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. Vet J. 2016; 207: 29–37.
• 10. Sellera FP, Nascimento CL, Ribeiro MS. Photodynamic therapy in veterinary medicine: From basics to clinical practice. In: Sellera FP, Nascimento CL, Ribeiro MS, eds. Cham: Springer; 2016: 169–196.
• 11. Li C, Jia X, Bian Y, Qi D, Wu J. Different susceptibility of spores and hyphae of Trichophyton rubrum to methylene blue mediated photodynamic treatment in vitro. Mycoses. 2021; 64(1): 48–54.
• 12. Abramowitz L, Benabderrahmane M, Pospait D, Philip J, Laouénan C. The prevalence of proctological symptoms amongst patients who see general practitioners in France. Eur J Gen Pract. 2014; 20(4): 301–306.
• 13. Hsieh, J. C., Hagermark, O., Stahle-Backdahl, M., Ericson, K., Eriksson, L, et al. Urge to scratch represented in the human cerebral cortex during itch. J Neurophysiol. 1994; 72(6): 3004–3008.
• 14. Etter L, Myers SA. Pruritus in systemic disease: Mechanisms and management. Dermatol Clin. 2002; 20(3): 459–472.
• 15. Ural, K., Gültekin, M., Erdoğan, H., Erdoğan, S., Gül, G, et al. Could short-term altered calendar probiotic treatment relieve itching in dogs with atopic dermatitis? Turk Klin J Vet Sci. 2020; 11: 1–8.
• 16. Ural K. Fecal microbiota transplantation capsule therapy via oral route for combatting atopic dermatitis in dogs. Ankara Univ Vet Fak Derg. 2022; 69(2): 211–219.
• 17. Ural, K., Erdoğan, H., Erdoğan, S., Camkerten, İ., & Şahin, N. Circulating serum zonulin levels before and after probiotic enema treatment in dogs with atopic dermatitis: Randomized clinical study. Turk Klin J Vet Sci. 2021; 12(2): 70–78.
• 18. Ural, K., Erdoğan, S., Erdoğan, H., Gültekin, M., Gül, G., et al. Köpeklerde Atopinin İyi, Kötü ve Çirkin Yönleri: Çoklu Olgu Serisi ile Retrospektif Çalışma. Türkiye Klinikleri Journal of Veterinary Sciences, 2020, 11(1).
• 19. Ural K, Gültekin M, Erdoğan S, Erdoğan H. Antipruritic armamentarium with short term nutritional support solution involving silymarin and curcumin for atopic dermatitis in dogs. MAE Vet Fak Derg. 2021; 6(1): 1–7.
• 20. Cosgrove SB, Wren JA, Cleaver DM, et al. A blinded, randomized, placebo-controlled trial of the efficacy and safety of the Janus kinase inhibitor oclacitinib (Apoquel®) in client-owned dogs with atopic dermatitis. Vet Dermatol. 2013; 24: 587–597.
• 21. Hill PB, Lau P, Rybnicek J. Development of an owner-assessed scale to measure the severity of pruritus in dogs. Vet Dermatol. 2007;18:301-308.
• 22. Moriello K, Coyner K, Paterson S, Mignon B. Diagnosis and treatment of dermatophytosis in dogs and cats: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Vet Dermatol. 2017;28(4):266–e68. https://doi.org/10.1111/vde.12440
• 23. Paryuni A, Indarjulianto S, SW S. Dermatophytosis in companion animals: A review.Vet World. 2020;13(6):1174–1181. https://doi.org/10.14202/vetworld.2020.1174-1181
• 24. Cabral FV, Sellera FP, Ribeiro MS. Methylene blue-mediated antimicrobial photodynamic therapy for canine dermatophytosis caused by Microsporum canis: A successful case report with 6 months follow-up. Photodiagnosis Photodyn Ther. 2021;36:102602.
• 25. Oz M, Lorke DE, Hasan M, Petroianu GA. Cellular and molecular actions of methylene blue in the nervous system. Med Res Rev. 2011;31(1):93–117.
• 26. Wainwright M, Crossley KB. Methylene blue: A therapeutic dye for all seasons? J Chemother. 2002;14(5):431–443.
• 27. An R. Atlas of the operations on the rectum and colon. Moscow Meduch Posovie; 1968.
• 28. Eusebio EB, Graham J, Mody N. Treatment of intractable pruritus ani. Dis Colon Rectum. 1990;33(9):770–772.
• 29. Kim JH, Kim DH, Lee YP. Long-term follow-up of intradermal injection of methylene blue for intractable, idiopathic pruritus ani. Tech Coloproctol. 2019;23(2):143–149.
• 30. Scigliano G, Scigliano GA. Methylene blue in COVID-19. Med Hypotheses. 2021;146:110455. https://doi.org/10.1016/j.mehy.2020.110455
• 31. Patidar V, Sharma A, Bhoraskar S, Tripathi AP, Dhaneriya S. The role of nebulized methylene blue (NMB) in the management of COVID-19 cases: An observational study. Int J Med Arts. 2022;4(2):2129–2132.
• 32. Alamdari DH, Moghaddam AB, Amini S, Keramati MR, Zarmehri AM, et al. Application of methylene blue-vitamin C-N-acetyl cysteine for treatment of critically ill COVID-19 patients: Report of a phase-I clinical trial. Eur J Pharmacol. 2020;885:173494. https://doi.org/10.1016/j.ejphar.2020.173494
• 33. Evora PR. Methylene blue is a guanylate cyclase inhibitor that does not interfere with nitric oxide synthesis. Tex Heart Inst J. 2016;43(1):103. https://doi.org/10.14503/THIJ15-5629
• 34. Rosique MJ, Rosique RG, Faria FM, Oliveira CC, Farina JA, et al. Methylene blue reduces progression of burn and increases skin survival in an experimental rat model. Burns. 2017;43(7):1702–1708.
• 35. Ostadhadi S, Haj-Mirzaian A, Azimi E, Mansouri P, Dehpour AJ. Involvement of nitric oxide in serotonin-induced scratching in mice. Clin Exp Dermatol. 2015;40(6):647–652.
• 36. Roosterman D, Goerge T, Schneider SW, Bunnett NW, Steinhoff M. Neuronal control of skin function: The skin as a neuroimmunoendocrine organ. Mol Pathol Biol. 2006;86(4):1309–1379.