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Sarcoids

Sarcoids


SARCOIDPAGE

"Sarcoids -
a name given to a spectrum of skin tumours considered to be an inflammatory systemic condition that produces tiny lumps of cells (granulomas) in and on the body. Granulomas are a mass of chronically inflamed tissue with granulations linked to a form of infection." 


The name ‘sarcoid’ was originally given to the human condition in 1936 by a Dr. Jackson, a pathologist in South Africa.  He used the name to describe the condition’s generally sarcomatous (tumourous) appearance.  Prior to that, the condition was simply termed ‘wart’. 

No matter what therapy is tried, you’ll read everything from ‘worked like a miracle’ to ‘didn’t help at all’.  One thing’s for certain though; they provide us humans with a level of hair-pulling frustration rarely seen with other equine conditions.

Personally I’ve not owned a horse with sarcoids, although my first pony attachment (pocket-rocket Charlie at the local riding stables when I was a child) had a horrid one on his left eyelid, year in and year out.  It was the shape and size of an adult human thumb, and every year it was banded off, yet sure as eggs are eggs it would grow right back again the next year. Which makes perfect sense - the sarcoid itself may have died through having its blood supply banded off, but the virus was still in Charlie's body to regrow right back.

Cut to today, and my former neighbour had a very charming Appaloosa who, as long as I’ve knew them (several years), had been afflicted with multiple sarcoids on his body, the worst being a large knarly growth, the size of a fist, literally surrounding his entire left eye socket.  It was incredibly sore for him, with many open wounds, bleeding and weeping.  My neighbour spent every spare waking moment researching a fix for him, and trying just about every treatment on the planet, including from the US.  Needless to say, everytime I saw her, we shared lengthy chats on all things sarcoids. 

Of course, over the years, whilst not knowing much about them, I’ve had my own instinctive thoughts and opinions on sarcoids.  Nevertheless, without any concrete evidential proof of any treatment actually working, whether natural or conventional, I’ve always been reluctant to promote any herbal support for the many enquiries I get for sarcoids, other than based around supporting immunity. 

I’ve always firmly believed that a poorly functioning immune system was somehow at the heart of sarcoids, and as we all know, immunity is at the very core of, well, everything.  If immunity is in some way compromised, ‘stuff’ happens. If there’s a healthy and fully functioning immune system, supported by a strong central nervous system, the body is equipped and ready with a strong resistance to have a darned good go at fighting whatever is thrown at it.


Here's what out there on sarcoids
* A quick heads-up here - all of the following are my condensed notes from my own research on sarcoids. Sources below and it's all out there on the web.

Continual research and studies of equine sarcoids are proving invaluable in our understanding of them, and thank goodness for it, because research at least knows what sarcoids are not.  They’re not a form of cancer or TB, neither are they AIDS-related or an airborne disease.  They’re also not contagious.


Sarcoids are the most common skin tumours to affect horses. They affect horses of all ages, breeds and colour. Six clinical types of sarcoids are recognised including occult, verrucose, nodular, fibroblastic, mixed and, sadly, malignant types.  There’re no guarantees on how sarcoids will behave on any horse or how they’ll respond to treatment.

The variety of treatment options used in clinical practice include everything from cryosurgery, laser surgery, BCG immunotherapy and chemotherapy, yet surgery appears to have a high failure rate due to the recurrence of the tumours.

There’s also an extensive range of every kind of topical formula, from manuka honey (of which I've read good reports), zinc chloride cream and toothpaste (seriously!).  Opinion time – personally I'm a bit on the fence regarding topical treatments for sarcoids, as I feel any topical interference could exacerbate the cell stimulation - I've not read any sound studies on this though, this is just my own take.  However, I specifically wouldn’t recommend Aloe Vera to be used topically on any sarcoid as it’s a known cell stimulator, and the last thing we need is to stimulate growth of the tumours.


What we can't argue with, though, is that with hundreds of different 'treatments' used world-wide for sarcoids, this is a huge sign that there’s no known guaranteed cure. Certainly, there appears to be no effective treatment that prevents recurrence.


Bovine papilloma virus
Research has identified that a well-known cause of equine sarcoids is via infection with Bovine Papillomaviruses (BPV) types 1 and 2 – it’s now even thought that strains of BPV may be equine specific.

However, the method of transmission is still unclear, although flies are thought to be a significant factor, specifically the Musca autumnalis (face-fly) breed.  The adult M.autumnalis wakes up from hibernation mid-spring and they just love cowpats.  Loaded with all kinds of yukkiness from the cow poo, they then feed on secretions around cattle and horse eyes, mouths and nostrils, mainly the female flies as they need extra protein provided by the animal host. They also love feeding on blood from horse-fly bites.  The female flies then lay their eggs on fresh cow poo which hatch into maggots pretty soon after. 10-20 days later, there’s gazillions of new pesky adult face-flies.


For the record, this is the route that my neighbour thought caused Appy’s sarcoids.  She consciously remembers a fly biting his eye and drawing blood; in all likelihood a pesky face-fly female landed with cowpat dribble on her feet and mouth.  As the saying goes, the rest is history.

(Science Alert: For the scientists out there, BPV-1/2 are non-enveloped double stranded DNA viruses with a genome of approximately 8kbp that infect their natural host, cattle, causing papillomas of skin or mucosa which generally regress without eliciting any serious clinical problems in the host. None of the treatment strategies for sarcoids directly target the viral infection, although vaccine studies in vivo have been successful and in vitro studies to knock down viral DNA expression appear to be effective in preventing growth of sarcoid fibroblasts.)


Interesting study results
Individual equine sarcoid biopsies have identified both BPV types 1 and 2 but … it’s not yet known whether BPV is present in all sarcoids. It’s also unknown if the virus is found in other equine skin tumours or even in normal skin.

However, the good news is that there are some pretty impressive statistics which prove it’s a major player.  A study from the University of California, Davis, looked for BPV DNA in 55 sarcoid-affected horses, taking biopsies from both the sarcoids themselves and unaffected normal skin areas. A further 22 horses without sarcoids were sampled for comparison, as were several non-sarcoid skin tumors.


This is big and deserves being in bold - Almost every sarcoid tumour examined (a whopping 98%) contained BPV DNA. 55% of horses with sarcoids had sarcoids with BPV-2, while 20% of those horses had BPV-1.  7% had both types of BPV present.

And the unaffected normal skin areas on the 55 sarcoid-afflicted horses?  A surprising 63% of the normal-skin samples contained BPV DNA. All the biopsies from horses without sarcoids, as well as biopsies of other non-sarcoid tumors, were negative.


Wow.  These findings suggest that BPV not only plays a role in sarcoid development, but is also capable of existing in a latent, non-virulent phase in normal skin. This certainly gives a reason as to why surgical removal of sarcoid tumours is rarely successful because it just removes the visible presentation, the symptom if you like. There’s even a suggestion that surgery might actually activate the latent virus and trigger the formation of new sarcoids. 


To conclude
If one of my horses developed sarcoids? Fly masks for sure, although the mouth would still be available for the flies. However, I'd be focusing on immunity as my priority, and obviously the gut microbiome, with lashings of natural antiviral/antibacterial physicks. If I really felt the itch to apply anything topical, I'd probably go for Manuka honey to draw the virus out. 

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Sources
American Journal of Veterinary Research, 62(5), 741-744, 2001.

Editor's Note: No research has suggested any risk of sarcoids from housing horses with cattle or on land previously inhabited by cattle.

MRC-University of Glasgow Centre for Virus Research, Institute of Infection, Inflammation and Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Bearsden Road, Glasgow, Scotland, G61 1QH, United Kingdom

Division of Life Sciences, University College, London, 5 University Street, London, WC1E 6JF, United Kingdom

Veterinary Research 2012, 43:81  doi:10.1186/1297-9716-43-81

http://www.veterinaryresearch.org/content/43/1/81

© 2012 Finlay et al.; licensee BioMed Central Ltd.