Is it the systemic inflammatory response syndrome or endotoxemia in horses with colic?

The use of serum paraoxonase-1 to assess inflammation in horses with colitis

BACKGROUND

Paraoxonase-1 (PON-1) has been suggested as a marker of inflammation and oxidative stress in horses and could potentially be used for prognostication in horses with colitis.

OBJECTIVES

Assessment of PON-1 in horses with colitis and comparison of two methods.

METHODS

Serum PON-1 was measured by two methods (paraoxon and p-nitrophenyl acetate) in 161 horses with colitis and 57 controls. Follow-up samples obtained during hospitalization were available from 106 horses with colitis. The two methods were compared.

RESULTS

Serum PON-1 was significantly lower in horses with colitis than in healthy horses (P < .0001 for both methods) as well as in nonsurvivors compared with survivors (P = .0141 [paraoxon-based method] and P < .0001 [p-nitrophenyl acetate-based method]), but with marked overlap between groups. PON-1 activity did not change parallel to a change in inflammatory status in response to treatment when assessed at admission and in up to seven follow-up samples. Admission PON-1 activity could not reliably classify horses as survivors or nonsurvivors, with sensitivity and specificity ranging between 53.1% and 72.9%. Results from the two methods were comparable.

CONCLUSIONS

Both methods reliably measured serum PON-1 activity. Significant differences in PON-1 activity were found between healthy horses and horses with colitis and between survivors and nonsurvivors. However, PON-1 activity varied considerably within groups. Both the proposed reference intervals as well as alternative cutoff values resulted in suboptimal diagnostic and prognostic performance, and the use of serum PON-1 in horses with colitis thus seems to add little to existing diagnostic and prognostic markers.

Pharmacologic Interventions to Immunologic and Immune-Mediated Conditions in Horses

Immunomodulators can stimulate, suppress, or regulate one or many aspects of the immune response. Use of a variety of immunostimulants, immunosuppressors, and anti-inflammatory drugs are described in horses, but the evidence supporting their efficacy is variable. Corticosteroids and nonsteroidal anti-inflammatory drugs are the best characterized immunomodulators in horses, but further study is needed to fully define their ideal dosing protocols and indications and to characterize the efficacy of other immunomodulators in equine medicine.

Association between Eosinophil Count and Cortisol Concentrations in Equids Admitted in the Emergency Unit with Abdominal Pain

Stress leukogram includes eosinopenia as one of its main markers (neutrophilia, eosinopenia, lymphopenia, and mild monocytosis). Cortisol is the main stress biomarker, which is also strongly correlated with the severity of gastrointestinal diseases. This study aimed to determine the relationship between salivary cortisol and the eosinophil cell count (EC) in equids with abdominal pain. To do this, 39 horses with abdominal pain referred to an emergency service were included. All samples were taken on admission, and several parameters and clinical data were included. Equids were classified according to the outcome as survivors and non-survivors. Non-surviving equids presented higher salivary cortisol concentrations (Non-Survivors: 1.580 ± 0.816 µg/dL; Survivors 0.988 ± 0.653 µg/dL; p < 0.05) and lower EC (Non-Survivors: 0.0000 × 103/µL (0.000/0.0075); Survivors: 0.0450 × 103/µL (0.010/0.1825); p < 0.01). In addition, the relationship between salivary cortisol concentration, EC, and the WBC was determined. Only a strong correlation (negative) was observed between cortisol and EC (r = -0.523, p < 0.01). Since cortisol is not an analyte that can be measured routinely in clinical settings such as emergencies, the EC could be a good alternative. While the results are promising, further studies are needed before EC can be used confidently in routine practice to predict survival in cases of abdominal pain.

Spontaneous Sepsis in Adult Horses: From Veterinary to Human Medicine Perspectives

Sepsis is a life-threatening disease defined as an organ dysfunction caused by a dysregulated host response to an infection. Early diagnosis and prognosis of sepsis are necessary for specific and timely treatment. However, no predictive biomarkers or therapeutic targets are available yet, mainly due to the lack of a pertinent model. A better understanding of the pathophysiological mechanisms associated with sepsis will allow for earlier and more appropriate management. For this purpose, experimental models of sepsis have been set up to decipher the progression and pathophysiology of human sepsis but also to identify new biomarkers or therapeutic targets. These experimental models, although imperfect, have mostly been performed on a murine model. However, due to the different pathophysiology of the species, the results obtained in these studies are difficult to transpose to humans. This underlines the importance of identifying pertinent situations to improve patient care. As humans, horses have the predisposition to develop sepsis spontaneously and may be a promising model for spontaneous sepsis. This review proposes to give first an overview of the different animal species used to model human sepsis, and, secondly, to focus on adult equine sepsis as a spontaneous model of sepsis and its potential implications for human and veterinary medicine.

Oral Administration of Meloxicam and Flunixin Meglumine Have Similar Analgesic Effects After Lipopolysaccharide-Induced Inflammatory Response in Thoroughbred Horses

Flunixin meglumine (FM), a nonselective cyclooxygenase (COX) inhibitor, is most frequently selected for the treatment of equine systemic inflammatory response syndrome (SIRS)/endotoxemia. However, FM has considerable adverse effects on gastrointestinal function. The aims of this study were to compare the effect of meloxicam (MX), a COX-2 selective inhibitor commonly used in equine clinical practice, with FM, and to investigate the potential for clinical application in horses with SIRS/endotoxemia. Fifteen horses were divided into three groups of five and orally administered MX (0.6 mg/kg), FM (1.1 mg/kg), or saline as placebo at 30 minutes after LPS challenge. Clinical parameters, including behavioral pain scores, were recorded and blood for clinical pathological data was collected at various times from 60 minutes before to 420 minutes after LPS infusion. The pain score were significantly lower in both the MX and FM groups than in the placebo group, with no significant difference between them. Body temperature was significantly lower in the MX and FM groups than in the placebo group. Heart rates and respiratory rates, hoof wall surface temperature, and leukocyte counts changed similarly between the MX and FM groups. TNF-α and cortisol were lower in the FM group than in the MX group. The results suggest that MX suppresses the inflammatory response after LPS infusion and has an analgesic effect similar to that of FM. Given the adverse effects of nonselective COX inhibitors, clinical application of MX may be beneficial in horses with SIRS/endotoxemia.

TLR4 and MD2 variation among horses with differential TNFα baseline concentrations and response to intravenous lipopolysaccharide infusion

Gram-negative bacterial septicemia is mediated through binding of lipopolysaccharide (LPS) to mammalian toll-like receptor protein 4 (TLR4). TLR4 and its cognate protein, myeloid differentiation factor 2 (MD2) form a heterodimeric complex after binding LPS. This complex induces a cascade of reactions that results in increased proinflammatory cytokine gene expression, including TNFα, which leads to activation of innate immunity. In horses, the immune response to LPS varies widely. To determine if this variation is due to differences in TLR4 or MD2, DNA from 15 healthy adult horses with different TNFα dynamics after experimental intravenous LPS infusion was sequenced across exons of TLR4 and MD2. Haplotypes were constructed for both genes using all identified variants. Four haplotypes were observed for each gene. No significant associations were found between either TNFα baseline concentrations or response to LPS and haplotype; however, there was a significant association (P value = 0.0460) between the baseline TNFα concentration and one MD2 missense variant. Three-dimensional structures of the equine TLR4-MD2-LPS complex were built according to haplotype combinations observed in the study horses, and the implications of missense variants on LPS binding were modeled. Although the sample size was small, there was no evidence that variation in TLR4 or MD2 explains the variability in TNFα response observed after LPS exposure in horses.

Plasma syndecan‐1 concentration as a biomarker for endothelial glycocalyx degradation in septic adult horses

BACKGROUND

Limited information is available regarding endothelial glycocalyx degradation during sepsis in horses. Plasma syndecan-1 concentrations are increased in consequence of sepsis in other species and have been useful for prognostication.

OBJECTIVES

To determine whether plasma syndecan-1 levels are increased in adult horses affected with sepsis.

STUDY DESIGN

Retrospective cohort study.

METHODS

Adult horses were assigned to one of three groups based on results of physical and laboratory examinations, clinical diagnosis, and results of previously described SIRS classification: Group 1 horses included healthy, nonseptic horses; Group 2 included horses in which clinical illness was identified but that were not considered to be septic; Group 3 included horses with a clinical diagnosis of sepsis. Plasma syndecan-1 concentration was determined in blood obtained at admission into the hospital for each horse, using an equine specific ELISA. Data were analysed using ANOVA and linear regression (p ≤ 0.05).

RESULTS

One hundred and ninety-one horses were included and divided into three groups. Scores for SIRS were highest for Group 3 horses and lowest in Groups 1 and 2. Plasma syndecan-1 concentrations in Group 3 horses (50.73 ± 84.24 μg/ml; n = 42) were greater than those for Group 1 (15.69 ± 11.28 μg/ml; n = 66) and Group 2 (16.88 ± 15.30 μg/ml; n = 83). There was no difference regarding syndecan concentrations between Groups 1 and 2.

MAIN LIMITATIONS

Retrospective study design, solitary time point of measurement for each patient, and lack of a widely accepted consensus regarding definitive diagnosis of sepsis in adult horses.

CONCLUSIONS

Circulating plasma levels of syndecan-1, a biochemical marker of endothelial glycocalyx damage, are increased in septic adult horses.

Plasma-Ionized Magnesium in Hospitalized Horses with Gastrointestinal Disorders and Systemic Inflammatory Response Syndrome

Simple Summary

Gastrointestinal diseases are the most prevalent diseases in hospitalized horses. One of the predisposing factors of decreased intestinal motility in horses with colic could be low plasma calcium concentration and related magnesium imbalances. Magnesium and calcium disturbances can predispose to decreased intestinal motility in horses with colic after abdominal surgery. Plasma ionized magnesium concentrations were measured in hospitalized horses with different types of gastrointestinal disorders (i.e., colic), horses with non-gastrointestinal diseases, horses with systemic inflammatory conditions and control horses; our results allowed us to conclude that hypomagnesemia was more prevalent in horses with obstructive gastrointestinal lesions. Surprisingly, no association was found with systemic inflammatory conditions nor with mortality. These valuable results suggest to us that magnesium concentrations in horses presenting obstructive colic should be monitored. Further research is needed to evaluate the effects of intravenous magnesium supplementation in horses with gastrointestinal diseases.

Abstract

Magnesium disorders in horses with gastrointestinal disorders or systemic inflammatory response syndrome (SIRS) are scarcely characterized. The purpose of the study was to explore the association of magnesium disorders with diagnosis, SIRS and mortality in horses admitted to a referral equine hospital. In total, 75 sick horses were included in an observational prospective study and classified as: obstructive (n = 17), inflammatory (n = 10) and ischemic gastrointestinal disorders (n = 12), and other non-gastrointestinal systemic disorders (n = 36). All sick horses were also divided according to the presence (n = 26) or absence of SIRS, and survival to discharge from hospital (survivors (n = 61) and non-survivors (n = 14). In addition, 26 horses were included as controls. On admission, mean (iMg) (95% confidence interval (CI)) in the SIRS group (0.47 (0.43–0.50 mmol/L)) was within the normal range (0.4–0.6 mmol/L). The obstructive group had lower (iMg) compared to the control group (0.44 (0.38–0.51 mmol/L) vs. 0.56 (0.50–0.61 mmol/L); p = 0.001). In total, 8 out of 17 (47%) horses with obstructive lesions presented with hypomagnesemia compared to controls (4% (1/26)) (p = 0.001). In conclusion, hypomagnesemia was more prevalent on admission in horses in the obstructive group, and to a lesser extent, in the inflammatory and ischemic groups. In contrast to human ICU patients, the proportion of hospitalized horses with hypomagnesemia was not associated with mortality.

Large bowel obstruction by enteroliths and/or foreign bodies in domestic equids: retrospective study of cases seen from January 2003 to March 2020

ABSTRACT This retrospective study was based on data extracted from medical records of 48 horses with intestinal obstruction caused by enteroliths and/or foreign bodies seen over the course of 17 years. Data analysis was aimed at describing the major features of this type of colic. Obstructions caused by enteroliths, foreign bodies or both accounted for 40 (83.34%), 6 (12.50%) and 2 (4.16%) cases in this sample respectively. Affected horses were aged 1 to 32 years (mean age 9.5 years) and 14 horses were fed alfalfa. Alfalfa is thought to contribute to enterolith formation. Foreign bodies and enteroliths were found in the transverse (12 cases, 25%), the large or the small colon (10 cases, 20.83% respectively). Concurrent obstruction of different intestinal segments was also recorded. These involved the small and the large colon in 10 cases (20.83%), the transverse and the large colon in 4 cases (8.33%), the small and the transverse colon in 1 case (2.08%) and the transition from the large to the transverse colon in one case (2.08%). Short term survival was 77.08% overall and 87.50% when only patients submitted to postoperative treatment were accounted for. Survival data are consistent with survival rates of 91% reported in literature.

Outcomes of pregnant broodmares treated for colic at a tertiary care facility

OBJECTIVE

To evaluate, following colic admission during pregnancy, (1) broodmare survival; (2) the frequency of recurrent colic in broodmares and its associated variables, and (3) pregnancy outcome and the variables associated with a negative pregnancy outcome.

STUDY DESIGN

Ambidirectional observational cohort study.

ANIMALS

One hundred and four client-owned broodmare admissions.

METHODS

Admissions of pregnant mares from June 2010 until October 2016 were included. Data were collected until November 2017. Cox proportional hazards regression analysis was performed to evaluate variables associated with broodmare survival. Logistic regression analysis was used to examine the variables associated with recurrent colic and pregnancy outcome.

RESULTS

Broodmares from 73/104 (70.2%) admissions were discharged alive. Lesion category, admission hyperlactatemia (hazard ratio (HR) 3.24, 95%, CI 1.28-8.22, P = .013), and admission high packed cell volume (HR 2.89, 95% CI 1.29-6.47, P = .010) were associated with reduced survival. Recurrent colic was observed in broodmares from 33/70 admissions (47.1%). The final multivariable model for recurrent colic included Thoroughbred breed (OR 5.09, 95% CI 1.58-16.4, P = .006) and age (OR .876, 95% CI .747-1.03, P = .105). Overall, negative pregnancy outcome was 14/65 (21.5%). Lesion category, evidence of systemic inflammatory response syndrome (SIRS) in hospital (OR 31.2, 95% CI 2.09-466.5, P = .013), and diarrhea in hospital (OR 379.3, 95% CI 97.1-1482.0, P < .001) were associated with increased negative pregnancy outcome. Altrenogest administration was inversely associated with negative pregnancy outcome (OR 0.029, 95% CI .004-.222, P = .001).

CONCLUSION

Pregnant broodmares admitted for colic had lower survival than anticipated and were at risk of recurrent colic. Markers of broodmare disease severity were associated with pregnancy outcome.

CLINICAL SIGNIFICANCE

Lesion category, hematologic variables (packed cell volume and l-lactate concentration), evidence of SIRS, and diarrhea were useful for predicting broodmare and pregnancy outcomes.

Evaluation of Plasmatic Procalcitonin in Healthy, and in Systemic Inflammatory Response Syndrome (SIRS) Negative or Positive Colic Horses

Simple Summary

Procalcitonin (PCT) increased in the case of systemic inflammatory response syndrome (SIRS), especially due to bacterial infection. The correlation between SIRS score and plasma PCT levels in horses have not been evaluated, and no studies investigated plasma PCT concentration over time. In the present study, PCT and SIRS score were evaluated in colic horses at admission to the hospital and at 24, 48, 72 and 96 h. Statistically differences were detected between healthy vs. all colic horses and between healthy vs. SIRS positive or SIRS negative horses. No correlation was observed between SIRS score and PCT. This suggests a role of plasmatic PCT as good biomarker for colic.

Abstract

Colic horses show systemic inflammatory response syndrome (SIRS) clinical signs. Procalcitonin (PCT) showed increased circulating levels in sick horses. This study compares plasma PCT concentrations in healthy vs. SIRS negative/positive colic horses over time, and evaluates PCT and SIRS score potential correlation, to verify the usefulness of PCT for the evaluation of SIRS severity. Ninety-one horses were included; 43/91 were healthy, on basis of physical examination, blood work and SIRS score (score = 0), while 48/91 were sick colic horses, classified as SIRS-negative (score < 2) and positive (score ≥ 2). Moreover, a 0–6 point-scale SIRS score was calculated (assessing mucous membrane color and blood lactate concentration). PCT was evaluated at admission, and at 24, 48, 72 and 96 h, using a commercial kit for equine species. We verified by the ANOVA test PCT differences between healthy vs. colic horses, healthy vs. SIRS-negative or SIRS-positive colic horses, at all sampling times, and the correlation between the SIRS score at admission with the SIRS score. Statistically significant differences were detected between healthy vs. all colic horses and between healthy vs. SIRS-positive or negative horses at all sampling times. No correlation was observed between the SIRS score at admission and PCT values. PCT was statistically higher in colic horses compared to the healthy ones, suggesting a role as a biomarker for colic.

Depletion of pulmonary intravascular macrophages rescues inflammation-induced delayed neutrophil apoptosis in horses

The objective of this study was to determine the effect of pulmonary intravascular macrophage depletion on systemic inflammation and ex vivo neutrophil apoptosis using an experimental model of intestinal ischemia and reperfusion injury in horses. Neutrophils were isolated before and after surgery from horses that were randomized to three treatment groups, namely, sham celiotomy (CEL, n = 4), intestinal ischemia and reperfusion (IR, n = 6), and intestinal ischemia and reperfusion with gadolinium chloride treatment to deplete pulmonary intravascular macrophages (PIMs, IRGC, n = 6). Neutrophil apoptosis was assessed with Annexin V and propidium iodide staining quantified with flow cytometry and caspase-3, caspase-8, and caspase-9 activities in neutrophil lysates. All horses experienced a systemic inflammatory response following surgery. Following surgery, ex vivo neutrophil apoptosis was significantly delayed after 12 or 24 h in culture, except in IRGC horses (12 h: CEL: P = 0.03, IR: P = 0.05, IRGC: P = 0.2; 24 h: CEL: P = 0.001, IR: P = 0.004, IRGC: P = 0.3). Caspase-3, caspase-8, and caspase-9 activities were significantly reduced in neutrophils isolated after surgery and cultured for 12 h in IR horses, but not in IRGC horses (IR caspase-3: P = 0.002, IR caspase-8: P = 0.002, IR caspase-9: P = 0.04). Serum TNF-α concentration was increased in IRGC horses for 6-18 h following jejunal ischemia. Following surgery, ex vivo equine neutrophil apoptosis was delayed via downregulation of caspase activity, which was ameliorated by PIM depletion potentially via upregulation of TNF-α.

Protective Effect of Silibinin on Lipopolysaccharide-Induced Inflammatory Responses in Equine Peripheral Blood Mononuclear Cells, an In Vitro Study

Simple Summary

Natural compounds are often an important source of biologically active molecules, which can find important applications in the treatment or pharmacological prevention of several pathologies. Silibinin is a natural polyphenolic flavonoid that is extracted from plant milk thistle, Silybum marianum. Silibinin has been reported to have antioxidant and immunomodulatory and anti-inflammatory activities. In horses, in particular, inflammation secondary to bacterial infection or translocation is one of the most frequent causes of morbidity and mortality. The aim of this study was to test the effect of silibinin on lipopolysaccharide (LPS)-induced inflammatory response in equine peripheral blood mononuclear cells (PBMCs). Taken together, our results showed an interesting prospective in therapeutic use of silibinin in equine inflammatory disease. Furthermore, the results from this study support the evidence of use equine PBMCs as an in vitro model to study inflammatory and immune response and for drug screening into the target specie.

Abstract

Although inflammation is an important physiological response, it plays a prominent role in several diseases across the mammalian species. In horses, in particular, inflammation secondary to bacterial infection or translocation is one of the most frequent causes of morbidity and mortality. Research in new molecules with anti-inflammatory and immunomodulatory proprieties and safe use profile is constantly an active field; natural compounds are an important source of molecules with peculiar properties such as antioxidants, anti-inflammatory and immune modulating. Silibinin, a natural polyphenolic flavonoid, extracted from plant milk thistle, Silybum marianum, has been reported to have actions such as antioxidant immunomodulatory and anti-inflammatory. The aim of this study was to test the effect of silibinin on lipopolysaccharide (LPS)-induced inflammatory response in equine peripheral blood mononuclear cells (PBMCs). Our results showed the protective effect of silibinin 10 μM and 50 μM in equine PBMCs stimulated with LPS. Silibilinin was able to prevent the LPS induced increased levels of TNF-α, IL-1β, IL-6 and IL-8. The results from this study on LPS-stimulated equine PBMCs showed that silibinin could be a useful pharmacological approach in treatment or prevention of several inflammatory conditions in horse.

Evaluation of Protein Carbonyl Content in Healthy and Sick Hospitalized Horses

Literature on the protein carbonyl content (PCC) evaluation in horses is scarce, thus the aims were to evaluate the PCC in healthy and SIRS (Systemic Inflammatory Response Syndrome) horses and to investigate the performances of PCC in terms of sensitivity, specificity, and likelihood ratio in identifying SIRS positive and negative horses. A total of 72 adult horses were included. All the horses underwent to a complete physical examination, blood analysis, and were evaluated for the SIRS status. Blood samples were collected once in healthy horses and at admission time, then 24, 48, 72, and 96 h after admission in sick animals. PCC was evaluated using a method previously described. Data were statistically analyzed to verify differences in PCC between healthy vs. SIRS positive or SIRS negative horses at all sampling time. The receiver operating characteristic (ROC) curve was performed to verify sensitivity and specificity of PCC in the diagnosis of SIRS-positive and SIRS negative horses. The healthy horses were standardbred mares with a median age of 8.5 years. The sick horses were 31/54 females, 16/54 geldings, and 7/54 stallions of different breeds and with a median age of 12 years old. Eight out of 54 sick horses were SIRS negative, while 46/54 were SIRS positive. Statistically significant differences were obtained between healthy and SIRS positive horses, while no differences were observed between healthy and SIRS negative horses at any sampling time. The best cutoff value of PCC to discriminate between SIRS positive, SIRS negative, and healthy horses, the sensitivity and specificity of cutoff point, the area under receiver operating characteristic curve, the 95% confidence intervals, and the likelihood ratio were reported. We found higher PCC values in sick SIRS-positive horses vs. healthy ones with a decrement over time, while no differences at admission, nor during the observational period, were obtained in sick but SIRS-negative horses. The value of 0.049 nmol/ml/mg is reported as a potential cutoff for the diagnosis of SIRS positivity vs. healthy horses with a sensibility of 74.5% and a specificity of 72.2%. In conclusion, PCC seems to be a sensitive and specific marker for SIRS in horses.

Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits

Simple Summary

Among sepsis biomarkers, procalcitonin resulted to be a specific indicator of bacterial infection or severity of infection, and to be a good control of the success of a therapeutic procedure. The clinical studies on the relevance of procalcitonin as a sepsis predictor in veterinary patients are few, likely due to the total absence of validated assays. For this reason, this study aimed to investigate commercial ELISA kits for the detection of canine and equine procalcitonin. Validation was performed evaluating linearity, limits of detection (LOD), recovery, and intra-assay and inter-assay variability; furthermore, clinical samples were analyzed. The results of the present study demonstrate that the human PCT ELISA kit is suitable to detect equine procalcitonin with a LOD of 56 ng/mL, and the canine recombinant PCT ELISA kit can be used to measure canine procalcitonin in plasma samples, showing an intra-assay and inter-assay coefficient of variation less than 20% and a LOD of 11 pg/mL.

Abstract

In human medicine, procalcitonin (PCT), the precursor of calcitonin, is used for the rapid identification of the origin and severity of sepsis. In veterinary medicine, PCT has been studied in horses, cattle, and dogs, but the use of PCT in diagnostic and/or prognostic settings is not possible because of the lack of validated assays to obtain reference ranges. The aim of the present study was the investigation of commercially available ELISA kits for the detection of canine and equine PCT in plasma samples. Validation of the ELISA kits was performed by using species-specific recombinant proteins spiked both in plasma and buffer samples; linearity, limit of detection (LOD), recovery, and intra-assay and inter-assay variability were calculated. Moreover, clinical samples obtained from sick and healthy animals were also analyzed with the tested kits. Canine PCT was measured with a recombinant canine and a canine PCT ELISA kit. Equine PCT was measured with an equine and a human ELISA PCT kit. Our data demonstrate that the canine recombinant PCT ELISA kit can be used to measure canine PCT in plasma samples, showing an intra-assay and inter-assay coefficient of variation less than 20% and a LOD of 11 pg/mL, whereas the present results do not support the use of the canine PCT ELISA kit. The human PCT ELISA kit is suitable to detect equine PCT with a LOD of 56 ng/mL, whereas the equine PCT ELISA kit did not detect recombinant equine PCT.

Ileal impaction resolution in a horse with colic via a standing right flank laparotomy ˗ case report

ABSTRACT This report describes a horse presenting ileal impaction that went through a right flank laparotomy procedure while standing. The decision to use this technique was made under the influence of several factors: the patient exhibited a calm temperament and demonstrated responsiveness to the analgesic treatment for pain control; the abdominal lesion was amenable to correction by a standing right flank approach. Also, the owner reported financial problems. Ileal obstruction was relieved successfully, and the horse recovery was satisfactory. This case highlights that, in specific cases of colic syndrome, the use of surgical procedures in the standing position might be a viable option and promote fast recovery.

Fibrinogen-Depleted Equine Platelet Lysate Affects the Characteristics and Functionality of Mesenchymal Stem Cells

Fetal bovine serum (FBS) is widely used to culture mesenchymal stem cells (MSCs) in the laboratory; however, FBS has been linked to adverse immune-mediated reactions prompting the search for alternative cell culture medium. Platelet lysate (PL) as an FBS substitute has been shown to promote MSCs growth without compromising their functionality. Fibrinogen contained in PL has been shown to negatively impact the immune modulating properties of MSCs; therefore, we sought to deplete fibrinogen from PL and compare proliferation, viability, and immunomodulatory capacities of MSCs in FBS or PL without fibrinogen. We depleted fibrinogen from equine platelet lysate (ePL) and measured platelet-derived growth factor-beta (PDGF-β), transforming growth factor-beta (TGF-β) and tumor necrosis factor-alpha (TNF-α) through ELISA. First, we determined the ability of 10% ePL or fibrinogen-depleted lysate (fdePL) compared with 10% FBS to suppress monocyte activation by measuring TNF-α from culture supernatants. We then evaluated proliferation, viability, and immunomodulatory characteristics of bone marrow-derived MSCs (BM-MSCs) cultured in FBS or ePL with or without fibrinogen. Growth factor concentrations decreased in ePL after fibrinogen depletion. Lipopolysaccharide (LPS)-stimulated monocytes exposed to ePL and fdePL produced less TNF-α than LPS-stimulated monocytes in 10% FBS. BM-MSCs cultured in fdePL exhibited lower proliferation rates, but similar viability compared with BM-MSCs in ePL. BM-MSCs in fdePL did not effectively suppress TNF-α expression from LPS-stimulated monocytes compared with BM-MSCs in FBS. Depleting fibrinogen results in a lysate that suppresses TNF-α expression from LPS-stimulated monocytes, but that does not support proliferation and immune-modulatory capacity of BM-MSCs as effectively as nondepleted lysate.

Effect of the p38 MAPK inhibitor doramapimod on the systemic inflammatory response to intravenous lipopolysaccharide in horses

Background

Doramapimod, a p38 MAPK inhibitor, is a potent anti‐inflammatory drug that decreases inflammatory cytokine production in equine whole blood in vitro. It may have benefits for treating systemic inflammation in horses.

Objective

To determine whether doramapimod is well tolerated when administered IV to horses, and whether it has anti‐inflammatory effects in horses in a low‐dose endotoxemia model.

Animals

Six Standardbred horses.

Methods

Tolerability study, followed by a blinded, randomized, placebo‐controlled cross‐over study. Horses were given doramapimod, and clinical and clinicopathological variables were monitored for 24 hours. Horses then were treated with doramapimod or placebo, followed by a low dose infusion of lipopolysaccharide (LPS). Clinical variables (heart rate, rectal temperature, noninvasive blood pressure), leukocyte count and tumor necrosis factor alpha (TNF‐α) and interleukin‐1 beta (IL‐1β) concentrations were measured at multiple time points until 6 hours post‐LPS infusion.

Results

No adverse effects or clinicopathological changes were seen in the safety study. When treated with doramapimod as compared to placebo, horses had significantly lower heart rates (P = .03), rectal temperatures (P = .03), and cytokine concentrations (P = .03 for TNF‐α and IL‐1β), and a significantly higher white blood cell count (P = .03) after LPS infusion.

Conclusions and Clinical Importance

Doramapimod has clinically relevant anti‐inflammatory effects in horses, likely mediated by a decrease in leukocyte activation and decrease in the release of pro‐inflammatory cytokines. To evaluate its potential as a novel treatment for systemic inflammatory response syndrome in horses, clinical trials will be necessary to determine its efficacy in naturally occurring disease.

Paraoxonase-1 activity evaluation as a diagnostic and prognostic marker in horses and foals

Background

In several species, paraoxonase‐1 (PON‐1) decreases during inflammation, because of the presence of oxidative stress; its measurement recently has been validated in horses, but its role as a clinical biomarker is unknown.

Objectives

To evaluate sensitivity, specificity and likelihood ratio of PON‐1 activity to identify systemic inflammatory response syndrome (SIRS)‐positive horses or horses with a poor prognosis.

Animals

One hundred seventy‐two blood samples from 58 sick horses from 3 different veterinary hospitals.

Methods

In a cross‐sectional study, PON‐1 activity was measured upon admission and at 24‐hour intervals until discharge or death, and results were analyzed based on SIRS status and outcome.

Results

No statistically significant difference was found in median PON‐1 activity between SIRS and non‐SIRS cases or between survivors and non‐survivors except for mares, in which PON‐1 activity was significantly lower in SIRS‐positive horses (P = .05). The sensitivity of PON‐1 activity in identifying horses with SIRS or negative outcome was low (0.0%‐46.2% depending on the examined group) but its specificity was high (87.0%‐100.0%). However, when PON‐1 is low, the likelihood of death is 2.40‐3.89 times higher than the likelihood of survival. Repeated measurement of PON‐1 after treatment does not predict outcome.

Conclusions and Clinical Importance

Evaluation of PON‐1 activity in horses with inflammation might be advisable in the future, but only low activity at admission may be relevant in predicting SIRS or negative outcome.

Anti-inflammatory effects of a p38 MAP kinase inhibitor, doramapimod, against bacterial cell wall toxins in equine whole blood

Doramapimod (BIRB-796-BS), is an anti-inflammatory compound, acting through p38 MAPK inhibition, but its anti-inflammatory effects have not previously been studied in the horse. Whole blood aliquots from healthy horses diluted 1:1 with cell culture medium were incubated for 21 h with 1 μg/ml of lipopolysaccharide (LPS), lipoteichoic acid (LTA) or peptidoglycan (PGN) in the presence of increasing concentrations of doramapimod (3 × 10^-8 M to 10^-5 M). Cell bioassays were used to measure TNF-α and IL-1β activity. Doramapimod significantly and potently inhibited TNF-α and IL-1β activity induced by all three bacterial toxins. There was no significant difference in IC₅₀ or maximum inhibition of TNF-α or IL-1β production between any of the toxins. Maximum inhibition of IL-1β was higher than that of TNF-α for all toxins, and this difference was significant for LPS (P = 0.04). Doramapimod was a potent inhibitor of TNF-α and IL-1β for inflammation induced by LPS, LTA and PGN, with potency much greater than that of other drugs previously tested using similar methods.

RAPID COMMUNICATION: TLR4 expressed but with reduced functionality on equine B lymphocytes

Varying susceptibility exists among mammalian species to the development of potentially fatal endotoxemia due to gram-negative bacteria molecular component, lipopolysaccharide (LPS). Toll-like receptor 4 (TLR4) is responsible for LPS-associated immune response and is expressed on numerous immune cells including B lymphocytes. TLR4 is expressed in a functional form on mouse B lymphocytes, a species much less susceptible to endotoxemia compared with humans who are highly sensitive to endotoxin. Humans possess B lymphocytes that are not responsive to LPS. Likewise, horses are highly susceptible to endotoxemia but the expression and function of TLR4 on horse B lymphocytes is not known. Colic, the major cause of mortality in horses, is often complicated by resultant endotoxemia. The objective of this study was to determine the expression and function of TLR4 on equine B lymphocytes. Lymphocytes were isolated from peripheral blood mononuclear cells that were collected from six horses, and the expression and function of TLR4 was analyzed for each horse. Flow cytometry results indicate TLR4 is expressed on horse B lymphocytes but stimulation with LPS did not alter this expression (P = 0.99) compared with unstimulated B lymphocytes after 24 h. After 72 h of in vitro LPS stimulation, analysis of cell proliferation dye by flow cytometry demonstrated that equine B lymphocytes did not proliferate, while mouse B lymphocytes predictably did. Furthermore, the total number of LPS stimulated equine B lymphocytes did not significantly differ from unstimulated cells after 72 h of culture (P = 0.92). Horse lymphocytes exhibited no significant differences in the measured TLR4 signaling pathway genes (TLR4, IL-10, IL-6, IFNβ, and TNFα) when expression was compared with LPS stimulated vs. unstimulated cells. In conclusion, while TLR4 is expressed on horse B lymphocytes, it appears minimally responsive to LPS in vitro, similar to results seen in human B lymphocytes. While further studies are still needed, our work reveals a potential link between B lymphocyte TLR4 expression and endotoxin sensitivity.

Are There Shared Mechanisms in the Pathophysiology of Different Clinical Forms of Laminitis and What Are the Implications for Prevention and Treatment?

Laminitis is a consequence of primary disease processes elsewhere in the body. The key pathophysiologic events are insulin dysregulation in endocrinopathic laminitis, ischemia in supporting limb laminitis, and inflammation in sepsis-related laminitis. These apparently disparate mechanisms converge to cause lamellar attachment failure through epithelial cell adhesion loss and stretch, possibly mediated by common growth factor signaling pathways. Tissue damage through mechanical distraction, inflammation, pain, and a proliferative epithelial healing response are features of acute laminitis regardless of the cause. Preventive and treatment strategies based on knowledge of these unique and common mechanistic events are likely to improve clinical outcomes.

A Comparative Review of Equine SIRS, Sepsis, and Neutrophils

The most recent definition of sepsis in human medicine can be summarized as organ dysfunction caused by a dysregulated host response to infection. In equine medicine, although no consensus definition is available, sepsis is commonly described as a dysregulated host systemic inflammatory response to infection. Defense against host infection is the primary role of innate immune cells known as neutrophils. Neutrophils also contribute to host injury during sepsis, making them important potential targets for sepsis prevention, diagnosis, and treatment. This review will present both historical and updated perspectives on the systemic inflammatory response (SIRS) and sepsis; it will also discuss the impact of sepsis on neutrophils, and the impact of neutrophils during sepsis. Future identification of clinically relevant sepsis diagnosis and therapy depends on a more thorough understanding of disease pathogenesis across species. To gain this understanding, there is a critical need for research that utilizes a clearly defined, and consistently applied, classification system for patients diagnosed with, and at risk of developing, sepsis.

Pharmacokinetics of Intrarectal Altrenogest in Horses

Hospitalized pregnant mares being held nil per os (PO) because of medical or surgical events present a dilemma for pregnancy maintenance therapy, which commonly includes oral altrenogest. Rectal administration of medications is a recognized route for achieving systemic concentrations, but there are no data on the pharmacokinetics of rectal altrenogest administration in horses. The purpose of this study was to determine the pharmacokinetics of altrenogest following PO or per rectum (PR) administration in mares. Using a randomized two-way crossover study design, six horses received altrenogest (0.088 mg/kg; PO or PR q 24 hours for 5 days), with a 7-day washout period, and the concentrations of altrenogest were determined by an ultrahigh performance liquid chromatography with tandem mass spectrometry. Plasma concentrations persisted above presumed therapeutic concentrations for a mean of 36 hours (range 24-72 hours) and 5.5 hours (range 3-8 hours) for PO and PR administration, respectively. The calculated half-life (T ½) of PO administration (7.01 ± 3.13 hours) was correspondingly increased when compared to PR administration (2.82 ± 1.07 hours). Relative bioavailability of altrenogest following PR administration was only 5.47%. Altrenogest is rapidly absorbed following PR administration in the horse and reaches therapeutic concentrations, making this a viable method of treatment in NPO mares. The decreased bioavailability and shorter detection time suggest 0.088 mg/kg PR q 4-8 hours would be necessary to maintain therapeutic concentrations over a 24-hour period.

Evaluating continuous blood coagulopathy in assessing the severity of acute colitis in Thoroughbred racehorses

Although severe blood coagulopathy in horses with acute colitis causes multiple organ failure, which may be fatal, few studies have focused on the correlation between the fluctuations of coagulation parameters and severity of colitis. In this study, we evaluated the fluctuations of coagulation parameters in 14 Thoroughbred racehorses with acute colitis for 5 days from the day of hospitalization and compared them between 5 survivors and 9 non-survivors. Noteworthy features in the non-survivors were that antithrombin activity and fibrin degradation products continuously decreased and increased, respectively, for 4 days or more and that thrombin-antithrombin complexes increased in the last 2 days before death. Thus, these parameters should be continuously monitored to observe these fluctuations in assessing the severity of acute colitis.

Blood glucose is unlikely to be a prognostic biomarker in acute colitis with systemic inflammatory response syndrome in Thoroughbred racehorses

Although hyperglycemia at admission with colic has been reported to have a poor prognosis, there is no report specifically about acute colitis with systemic inflammatory response syndrome (SIRS) in horses. In this study, we measured blood glucose (Glu), insulin (Ins), and cortisol (Cor) levels in 17 Thoroughbred racehorses diagnosed as having acute colitis with SIRS, and examined the relationship between time-dependent changes in Glu, Ins, and Cor and prognosis. Glu levels were high in 3 horses at admission, but thereafter no horses had persistently high Glu levels. There was no significant difference in Glu, Ins, and Cor levels within 72 hr between surviving and non-surviving horses. In conclusion, the Glu level is unlikely to be a useful prognostic biomarker in acute colitis with SIRS.

Advances in Diagnostics and Treatments in Horses with Acute Colic and Postoperative Ileus

Differentiating between medical and surgical causes of colic is one of the primary goals of the colic workup, because early surgical intervention improves prognosis in horses requiring surgery. Despite the increasing availability of advanced diagnostics (hematologic analyses, abdominal ultrasound imaging, etc), the most accurate indicators of the need for surgery remain the presence of moderate to severe signs of abdominal pain, recurrence of pain after appropriate analgesic therapy, and the absence of intestinal borborygmi. Investigation of novel biomarkers, which may help to differentiate surgical lesions from those that can be managed medically, continues to be an active area of research.

Innate immune responses of equine monocytes cultured in equine platelet lysate

Platelet lysate (PL) has been extensively used for the laboratory expansion of human mesenchymal stem cells (MSC) in order to avoid fetal bovine serum (FBS) which has been associated with immune-mediated host reactions and transmission of bovine-origin microbial contaminants. Before suggesting the routine use of PL for MSC culture, we wanted to further investigate whether PL alone might trigger inflammatory responses when exposed to reactive white blood cells such as monocytes. Our objectives were to evaluate the inflammatory profile of equine monocytes cultured with equine PL (ePL) and to determine if ePL can modulate the expression of inflammatory cytokines in lipopolysaccharide (LPS)-stimulated monocytes. In a first experiment, equine monocytes were isolated and incubated with donor horse serum (DHS), FBS, six individual donors ePL or pooled ePL from all horses. In a second experiment, monocytes were stimulated with E. coli LPS in the presence of 1, 5 or 10% DHS and/or pooled ePL. After 6h of incubation, cell culture supernatants were assayed via ELISA for production of the pro-inflammatory cytokines tumor necrosis factor alpha (TNF-α) and Interleukin 1β (IL-1β) as well as for the anti-inflammatory Interleukin 10 (IL-10). Equine monocytes incubated with pooled ePL produced significantly less TNF-α and significantly more IL-10 than monocytes incubated in FBS. A statistically significant difference was not identified for the production of IL-1β. The second experiment showed that pooled ePL added to LPS-stimulated equine monocytes resulted in a significant reduction in TNF-α and IL-1β production. IL-10 production was not significantly upregulated by the addition of ePL to LPS-stimulated monocytes. Finally, the addition of ePL to LPS-stimulated monocytes in the presence of various concentrations of DHS resulted to statistically significant decrease of TNF-α and IL-1β compared to the control groups. This is the first study to demonstrate that ePL suppresses the release of pro-inflammatory cytokines from stimulated equine monocytes. These results encourage further exploration of PL as a homologous media substitute for FBS but also opens the possibility of investigating its use as means to suppress cell-mediated inflammation.

Characterization of basal and lipopolysaccharide-induced microRNA expression in equine peripheral blood mononuclear cells using Next-Generation Sequencing

The innate immune response to lipopolysaccharide contributes substantially to the morbidity and mortality of gram-negative sepsis. Horses and humans share an exquisite sensitivity to lipopolysaccharide and thus the horse may provide valuable comparative insights into this aspect of the inflammatory response. MicroRNAs, small non-coding RNA molecules acting as post-transcriptional regulators of gene expression, have key roles in toll-like receptor signaling regulation but have not been studied in this context in horses. The central hypothesis of this study was that lipopolysaccharide induces differential microRNA expression in equine peripheral blood mononuclear cells in a manner comparable to humans. Illumina Next Generation Sequencing was used to characterize the basal microRNA transcriptome in isolated peripheral blood mononuclear cells from healthy adult horses, and to evaluate LPS-induced changes in microRNA expression in cells cultured for up to four hours. Selected expression changes were validated using quantitative reverse-transcriptase PCR. Only miR-155 was significantly upregulated by LPS, changing in parallel with supernatant tumor necrosis factor-α concentration. Eight additional microRNAs, including miR-146a and miR-146b, showed significant expression change with time in culture without a clear LPS effect. Target predictions indicated a number of potential immunity-associated targets for miR-155 in the horse, including SOCS1, TAB2 and elements of the PI3K signaling pathway, suggesting that it is likely to influence the acute inflammatory response to LPS. Gene alignment showed extensive conservation of the miR-155 precursor gene and associated promoter regions between horses and humans. The basal and LPS-stimulated microRNA expression pattern characterized here were similar to those described in human leukocytes. As well as providing a resource for further research into the roles of microRNAs in immune responses in horses, this will facilitate inter-species comparative study of the role of microRNAs in the inflammatory cascade during endotoxemia and sepsis.

Effect of choline chloride premedication on xylazine-induced hypoxaemia in sheep

OBJECTIVE

To determine the anti-inflammatory efficacy of choline in vivo and in vitro and to investigate the anti-inflammatory mechanisms of choline.

STUDY DESIGN

Randomized, controlled studies.

ANIMALS

In vivo trials used 16 Romney sheep. In vitro experiments utilized RAW 264.7 mouse macrophage cells.

METHODS

Hypoxaemia induced in 16 sheep by intravenous (IV) injection of 50 μg kg^-1 xylazine, an α-2 agonist, was measured in sheep at 0, 1 and 4 minutes using arterial blood gas analysis with and without 50 mg kg^-1 IV choline chloride premedication. Cell culture studies used enzyme-linked immunosorbent assay to measure the release of tumour necrosis factor (TNF-α) from lipopolysaccharide (LPS) stimulated macrophages with and without choline chloride premedication. TNF-α release was compared to thalidomide suppressed and untreated cells.

RESULTS

Choline premedication in sheep mitigated a reduction in arterial partial pressure of oxygen (PaO₂) but did not prevent development of clinically significant hypoxaemia. Decrease in mean PaO₂ of choline treated sheep was 6.36 kPa (47.7 mmHg) compared to 9.81 kPa (73.6 mmHg) in control sheep. In vitro studies demonstrate that choline administered concurrent with LPS activation did not significantly suppress TNF-α expression but that treatment of cells with choline 10 minutes prior to LPS activation did significantly suppress TNF-α expression. Choline pretreated cells expressed 23.99 ± 4.52 ng mg^-1 TNF-α while LPS only control cells expressed 33.83 ± 3.20 ng mg^-1.

CONCLUSIONS

Choline is able to prevent macrophage activation in vitro when administered prior to LPS activation and may reduce hypoxaemia in sheep developing pulmonary oedema after xylazine administration. This effect requires premedication with choline.

CLINICAL RELEVANCE

Pharmacological manipulation of autonomic inflammatory responses holds promise for the treatment of inflammation. However, the complex cellular mechanisms involved in this reflex means that an adequate therapy should approach multiple pathways and mechanisms of the inflammatory response.

Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome

Background

Despite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown.

Objectives

To study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome.

Animals

A total of 479 consecutive adult horse emergency admissions to a private primary referral practice.

Methods

Prospective observational study. All adult horses admitted for emergency treatment over the study period were included. Multivariate logistic regression and stepwise model selection were used.

Results

Each of the 4 SIRS criteria was associated with outcome in this population. Thirty‐one percent of emergency cases had 2 or more abnormal SIRS criteria on admission and were defined as SIRS cases. SIRS was associated with increased odds of death (odds ratio [OR] = 8.22; 95% CI, 4.61–15.18; P < .001), an effect mainly found for acute gastrointestinal cases. SIRS cases were assigned a SIRS score of 2, 3, or 4, according to the number of abnormal SIRS criteria fulfilled on admission, and SIRS3 and SIRS4 cases had increased odds of death compared to SIRS2 cases (OR = 4.45; 95% CI, 1.78–11.15; P = .002). A model of severe SIRS including the SIRS score, blood lactate concentration, and color of the mucous membranes best predicted outcome in this population of horses.

Conclusions and Clinical Importance

Systemic inflammatory response syndrome is associated with an increased risk of death in adult horses presenting with acute gastrointestinal illnesses. The model of severe SIRS proposed in this study could be used to assess the status and prognosis of adult equine emergency admissions.

Kinetics of plasma procalcitonin, soluble CD14, CCL2 and IL-10 after a sublethal infusion of lipopolysaccharide in horses

Endotoxemia represents a significant clinical and economic problem for the equine industry. This study assesses the kinetics of soluble CD14 (sCD14), chemokine (CC motif) ligand 2 (CCL2), interleukin 10 (IL-10) and plasma procalcitonin (PCT) in healthy horses after the intravenous infusion of lipopolysaccharide (LPS). The aim was to contribute to the basic understanding of the equine species-specific kinetics of these molecules in response to LPS exposure, which could support further findings in clinical studies and identify valuable inflammatory biomarkers for equine practice. Eleven healthy horses were involved in this experimental in vivo study. Horses were classified as healthy before the LPS infusion. After the pre-infusion blood collection (T0), all horses received an infusion of E. coli endotoxin (30ng/kg over 30min). Data and samples were collected 1h (T1), 2 (T2), 3 (T3) and 24h (T24) after infusion. Plasma sCD14, CCL2 and IL-10 were evaluated with a fluorescent bead-based assay, while PCT was evaluated with an equine PCT ELISA assay. A one-way ANOVA test was performed between each blood-sampling time for PCT, sCD14 and IL-10, and a Friedman test was performed for CCL2. Plasma PCT, IL-10 and CCL2 concentrations increased statistically significantly at T1, T2 and T3 compared to T0. No statistically significant differences were found between plasma IL-10 and CCL2 concentrations between T0 vs T24, although plasma PCT values remained high 24h after LPS infusion. Plasma sCD14 concentration showed no statistically significant differences for any of sampling times. Our results demonstrate that LPS injection into healthy horses results in PCT, CCL2 and IL-10 increases in plasma without an increase in sCD14. The increases in PCT, CCL2 and IL-10 are related to the inflammatory response induced by circulating lipopolysaccharide.

Neutrophil apoptosis is delayed in an equine model of colitis: Implications for the development of systemic inflammatory response syndrome

BACKGROUND

Horses that develop colitis invariably exhibit signs of a systemic inflammatory response syndrome (SIRS). A significant contributor to the development of SIRS in human subjects is delayed neutrophil apoptosis, but this has not been specifically studied in horses.

OBJECTIVES

To determine the occurrence of ex vivo neutrophil apoptosis and its contribution to the development of SIRS in an equine colitis model.

STUDY DESIGN

Experiment using a colitis model.

METHODS

Neutrophils were isolated before and after the induction of colitis using an oligofructose overdose model, placed into culture for 12 h or 24 h with or without lipopolysaccharide (LPS) at various concentrations, and assessed for the occurrence of apoptosis using Annexin V and propidium iodide staining with flow cytometric quantification. Levels of caspase-3, -8 and -9 activity were measured after 12 h of incubation in neutrophil lysates.

RESULTS

Ex vivo neutrophil apoptosis was significantly delayed in neutrophils isolated after the induction of colitis (12-h incubation: P = 0.004; 24-h incubation: P = 0.003) with concomitant reductions in caspase-3, -8 and -9 activity (caspase-3: P = 0.004; caspase-8: P = 0.02; caspase-9: P = 0.02). Neutrophils isolated after the induction of colitis were refractory to LPS-delayed apoptosis. Neutrophil apoptosis was delayed with increasing cell concentration in vitro.

MAIN LIMITATIONS

The main limitation of the study is the that the exact mechanism for delayed neutrophil apoptosis following the induction of colitis was not fully elucidated.

CONCLUSIONS

The data show that neutrophil apoptosis is delayed in horses following the induction of colitis as a result of interference with the intrinsic and extrinsic apoptotic pathways, which may contribute to the development of equine SIRS. Concurrent development of neutrophilia may contribute to a prolonged neutrophil lifespan through a concentration-dependent delay in apoptosis.

Oxidative stress in hoof laminar tissue of horses with lethal gastrointestinal diseases

Tissue damage caused by oxidative stress is involved in the pathogenesis of several diseases in animals and man, and is believed to play a role in the development of laminitis in horses. The aim of this study was to investigate the oxidative stress associated with laminar lesions in horses with lethal gastrointestinal disorders. Laminar tissue samples of the hoof of 30 horses were used. Tissue samples were divided as follows: six healthy horses (control group-CG), and 24 horses that died after complications of gastrointestinal diseases (group suffering from gastrointestinal disorders-GDG). Superoxide dismutase (SOD2) and nitrotyrosine immunostaining and the severity of laminar lesions were evaluated. Presence of laminar lesions and immunostaining for nitrotyrosine and SOD2 were only evident in horses from the GDG group. Thus, oxidative stress may play a role in the pathogenesis of laminar lesions secondary to gastrointestinal disorders.

Plasma HMGB-1 and Nucleosome Concentrations in Horses with Colic and Healthy Horses

Background

Acute gastrointestinal disease occurs commonly in horses. Novel biomarkers might improve the understanding of SIRS and aid diagnosis and determination of prognosis.

Hypotheses

Increased plasma concentrations of the biomarkers HMGB‐1 and nucleosomes are associated with severity of gastrointestinal lesions in horses; concentrations of these biomarkers will be greater in horses with lesions more likely to cause SIRS; and will provide additional information compared with standard biomarkers fibrinogen and SAA.

Animals

Thirty horses with gastrointestinal disease, 22 healthy horses.

Methods

Prospective study. Plasma samples taken on admission were used for measurement of HMGB‐1, nucleosomes, fibrinogen, and SAA. Values were compared between healthy horses and those with gastrointestinal disease, and between horses with gastrointestinal disease grouped by lesion type (inflammatory, strangulating, and nonstrangulating). Correlations between biomarkers were assessed.

Results

Plasma concentrations of all biomarkers were significantly higher in horses with gastrointestinal disease compared to healthy horses (P ≤ .001). HMGB‐1 and nucleosomes were significantly higher in inflammatory and strangulating groups compared to healthy horses (3.5‐fold and 5.4‐fold increases, respectively, for HMGB‐1 (P < .05) and 4.8‐fold and 5.6‐fold increases for nucleosomes (P < .05)), but concentrations in the group with nonstrangulating disease did not differ from healthy horses. There was significant correlation between HMGB‐1 and nucleosomes (Spearman's r = 0.623; P < .001), and fibrinogen and SAA (Spearman's r = 0.801; P < .001) but not between other biomarkers.

Conclusions and Clinical Importance

High mobility group box‐1 and nucleosomes might have use as biomarkers for horses with gastrointestinal disease. Further studies are required to determine kinetics and prognostic value of serial measurements of these biomarkers in horses.

Plasma Procalcitonin Concentration in Healthy Horses and Horses Affected by Systemic Inflammatory Response Syndrome

BACKGROUND

The diseases most frequent associated with SIRS in adult horses are those involving the gastrointestinal tract. An early diagnosis should be the goal in the management of horses with SIRS.

OBJECTIVE

The objective of this study was to evaluate the plasma procalcitonin (PCT) concentration in healthy and SIRS horses to assess differences between the two groups.

ANIMALS

Seventy-eight horses (30 healthy and 48 SIRS).

METHODS

Prospective in vivo multicentric study. Horses were classified as SIRS if at least 2 of the following criteria were met: abnormal leukocyte count or distribution, hyperthermia or hypothermia, tachycardia, tachypnea. Healthy horses showed no clinical or laboratory signs of SIRS. Plasma PCT concentrations were measured with a commercial ELISA assay for equine species. Results were expressed as mean±standard deviation. T-test for unpaired data was performed between healthy and SIRS group. SIRS group was divided in 4 subgroups and t-test was performed between healthy versus each subgroup.

RESULTS

PCT concentrations in healthy and SIRS horses were 18.28 ± 20.32 and 197.0 ± 117.0 pg/mL, respectively. T-test showed statistical differences between healthy versus SIRS group and between healthy versus all subgroups.

CONCLUSIONS AND CLINICAL IMPORTANCE

Results showed an increase in PCT concentration in SIRS horses as previously reported in humans and dogs. PCT could be used as a single assay in equine practice for detection of SIRS.