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Strict phenotyping and identification of subclinically asthmatic horses can be challenging. The aim of this study was to describe equine asthma phenotypes (mild, moderate, and severe asthma) defined by BALF cytology and occurrence of clinical signs in a population of privately owned horses and to identify the variables and examination steps with best discriminative potential. The standardised examination protocol included clinical examinations, blood work, airway endoscopy with bronchoalveolar lavage fluid analysis, arterial blood gas analysis and radiography under clinical conditions performed by one veterinarian.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 26 horses, four were diagnosed with mild (subclinical), seven with moderate, and seven with severe asthma based on clinical examination and BALF cytology. Eight horses served as controls. Cough with history of coughing was the strongest variable in phenotype differentiation. Factor analysis revealed an increasing clinical variability with disease severity and an overlapping of clinical presentations between phenotypes. Elevated mast cell (4\/4 horses) and neutrophil counts (3\/4 horses) in bronchoalveolar lavage cytology differentiated mild asthmatic horses from healthy horses. Moderate and severe asthmatic horses were characterised by clinical signs and neutrophil counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results indicate that medical history, clinical examination and bronchoalveolar lavage cytology are minimum indispensable steps to diagnose equine asthma and that phenotypes are clinically overlapping. A differentiation of three phenotypes without neutrophil and mast cell counts in bronchoalveolar lavage cytology is not sufficient for clinical diagnostics. A comparably exact diagnosis cannot be achieved by relying on alternative examinations used in this study. Screenings of inconspicuous horses with bronchoalveolar lavage can aid in diagnosing subclinically affected animals, however, group size was small, the procedure is invasive and clinical relevance of slightly elevated cells in bronchoalveolar lavage remains unclear. Clinical relevance could not be clarified in this study, since follow-up examinations or lung function testing were not performed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13028-024-00773-7","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T15:35:37Z","timestamp":1726760137000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical variability of equine asthma phenotypes and analysis of diagnostic steps in phenotype differentiation"],"prefix":"10.1186","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1050-3142","authenticated-orcid":false,"given":"Lia Kristin","family":"Meiseberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-3499","authenticated-orcid":false,"given":"Julien","family":"Delarocque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4516-7838","authenticated-orcid":false,"given":"Nicole","family":"de Buhr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Ohnesorge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"773_CR1","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/jvim.13824","volume":"30","author":"LL Cou\u00ebtil","year":"2016","unstructured":"Cou\u00ebtil LL, Cardwell JM, Gerber V, Lavoie JP, L\u00e9guillette R, Richard EA. 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The animals were handled according to high ethical standards and national legislation. However, the examination protocol was evaluated in association with a study registered and approved by the Ethics Committee of the University of Veterinary Medicine Hannover, Foundation, and the State Office for Consumer Protection and Food Safety (LAVES) in accordance with the German Animal Welfare Law under the Reference: 33.9-42502-05-21A626.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Owners gave written, informed consent for the further usage of data and samples for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"51"}}