| + | Organic dusts contain a variety of components that can initiate lung inflammation. These include specific allergens, endotoxin, components of molds such as beta-glucan, and small particulates. Elevated levels of specific IgE in bronchoalveolar lavage fluid (BALF) [8] favor the hypothesis that RAO is initiated by an allergic response to thermophilic molds and actinomycetes such as Faeni rectivirgula. A similar increase in specific IgE could not be documented in horses with SPAOD [9]. More recent studies examining the cytokine responses in both RAO and SPAOD lean toward a TH2 (allergic) immune response [10]. However, it has proved impossible to induce the heaves syndrome simply by administration of molds to susceptible horses [11-13]. Hay and stable dust contains endotoxin [7] and it is known from work in other species that administration of endotoxin into the airways can also induce many of the changes typical of RAO such as neutrophilic inflammation and mucus hypersecretion [14]. Small particles and fibers landing on the surface of the epithelium also can initiate the release of pro-inflammatory cytokines such as IL-8 [15,16]. Because organic dusts contain such a mixture of materials, RAO and SPAOD probably are initiated by several of these factors acting in concert. A genetic susceptibility to these diseases is suggested by the observation that many horses are housed without apparent problems in environments that can provoke airway obstruction in a RAO susceptible horse. Evidence in support of such a genetic component does exist |