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Nocera I, Sgorbini M, Meucci V, Gracia-Calvo LA, Tapio H, Camisi M, Sala G, Citi S. Procalcitonin and carbonylated protein concentrations in equine synovial fluid. Vet Res Commun 2024; 48:1263-1269. [PMID: 38127161 DOI: 10.1007/s11259-023-10280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Early diagnosis of joint diseases is fundamental for prompt and appropriate management, particularly in septic arthritis. Procalcitonin (PCT) and protein carbonylated content (PCC) have been investigated in both human and veterinary medicine. An increase in PCT has been shown in infectious bacterial diseases, while higher levels of PCC have been shown in inflammatory pathologies characterized by oxidative damage. This study evaluated PCT and PCC in plasma and synovial fluid (SF), in healthy and pathological equine joints, affected by different types of arthropathy. Twenty-nine joints were evaluated and underwent orthopedic, radiographic, ultrasonographic and SF evaluation. The joints were divided in three groups: healthy, septic, and non-septic arthritis. PCT and PCC were measured in horse plasma and SF. Data distribution was evaluated and results were expressed as median, quartile values. Statistical differences in SF values among groups and correlations were assessed between plasma and SF of both PCT and PCC. The groups of joint disease included: 8/29 healthy, 13/29 non-septic and 8/29 septic. Significant differences were obtained for SF PCC and plasma PCT between healthy and septic joints, while no differences were found for plasma PCC and SF PCT. A positive correlation was found between plasma and SF PCT. To the best of our knowledge, this is the first study reporting PCT in equine SF. SF PCC could be a useful biomarker to differentiate between septic and healthy joints.
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Affiliation(s)
- Irene Nocera
- Institute of Health Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy.
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy.
| | - Micaela Sgorbini
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Valentina Meucci
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | | | - Heidi Tapio
- Veterinary Teaching Hospital, University of Helsinki, Helsinki, Finland
| | - Marcello Camisi
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Giulia Sala
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
| | - Simonetta Citi
- Department of Veterinary Sciences, Veterinary Teaching Hospital, University of Pisa, Pisa, Italy
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2
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Sala G, Orsetti C, Meucci V, De Marchi L, Sgorbini M, Bonelli F. Case-Control Study: Endogenous Procalcitonin and Protein Carbonylated Content as a Potential Biomarker of Subclinical Mastitis in Dairy Cows. Vet Sci 2023; 10:670. [PMID: 38133221 PMCID: PMC10747190 DOI: 10.3390/vetsci10120670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/13/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Procalcitonin (PCT) and protein carbonylated content (PCC) are promising biomarkers for bacterial infection and inflammation in veterinary medicine. This study examined plasma PCT and PCC levels in healthy cows (H) and cows with subclinical mastitis (SCM). A total of 130 cows (65 H and 65 SCM) were included in this study. Blood samples were collected, and plasma was frozen at -80 °C. PCT levels were determined using a bovine procalcitonin ELISA kit, while PCC was measured following the methodology of Levine et al. Statistical analysis revealed a significant difference in PCT levels between H (75.4 pg/mL) and SCM (107.3 pg/mL) cows (p < 0.001) and significantly lower concentrations of PCC in the SCM group (H: 0.102 nmol/mL/mg, SCM: 0.046 nmol/mL/mg; p < 0.001). The PCT cut-off value for distinguishing healthy and subclinical mastitis animals was >89.8 pg/mL (AUC 0.695), with a sensitivity of 66.2% and specificity of 69.2%. PCT showed potential value as a diagnostic tool to help in decision making for subclinical mastitis cases, while PCC requires further studies to investigate the trend of this biomarker during localized pathology.
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Affiliation(s)
- Giulia Sala
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, San Piero a Grado (PI), 56122 Pisa, Italy
| | - Chiara Orsetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, San Piero a Grado (PI), 56122 Pisa, Italy
| | - Valentina Meucci
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
| | - Lucia De Marchi
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, San Piero a Grado (PI), 56122 Pisa, Italy
| | - Francesca Bonelli
- Department of Veterinary Sciences, University of Pisa, Via Livornese s.n.c., San Piero a Grado, 56122 Pisa, Italy; (C.O.); (V.M.); (L.D.M.); (M.S.); (F.B.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, San Piero a Grado (PI), 56122 Pisa, Italy
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3
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Jacobsen S. Use of serum amyloid A in equine medicine and surgery. Vet Clin Pathol 2023; 52 Suppl 1:8-18. [PMID: 36336845 DOI: 10.1111/vcp.13195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/10/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022]
Abstract
Serum amyloid A (SAA) has become an indispensable part of the management of equine patients in general practice and specialized hospital settings. Although several proteins possess acute phase properties in horses, the usefulness of SAA exceeds that of other acute phase proteins. This is due to the highly desirable kinetics of the equine SAA response. SAA concentrations exhibit a rapid and pronounced increase in response to inflammation and a rapid decline after the resolution of inflammation. This facilitates the detection of inflammatory disease and real-time monitoring of inflammatory activity. SAA may be used in all stages of patient management: (1) before diagnosis (to rule in/rule out inflammatory disease), (2) at the time of diagnosis (to assess the severity of inflammation and assist in prognostication), and (3) after diagnosis (to monitor changes in inflammatory activity in response to therapy, with relapse of disease, or with infectious/inflammatory complications). By assessing other acute phase reactants in addition to SAA, clinicians can succinctly stage inflammation. White blood cell counts and serum iron concentration change within hours of an inflammatory insult, SAA within a day, and fibrinogen within 2-3 days; the interrelationship of these markers thus indicates the duration and activity of the inflammatory condition. Much research on the equine SAA response and clinical use has been conducted in the last decade. This is the prerequisite for the evidence-based use of this analyte. However, still today, most published studies involve a fairly low number of horses. To obtain solid evidence for use of SAA, future studies should be designed with larger sample sizes.
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Affiliation(s)
- Stine Jacobsen
- Department of Veterinary Clinical Sciences, Section Medicine & Surgery, University of Copenhagen, Copenhagen, Denmark
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4
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Bonelli F, Madrigali A, Sgorbini M, Meucci V, Battaglia F, Guélat-Brechbuehl M, Sala G, Meylan M. Case - Control study: Evaluation of plasma procalcitonin concentration as an indicator of inflammation in healthy and sick cows. Res Vet Sci 2023; 155:56-61. [PMID: 36634543 DOI: 10.1016/j.rvsc.2023.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
This case - control study aims to evaluate Procalcitonin (PCT) plasma concentrations in healthy and hospitalized cows with a conclusive diagnosis of inflammation due to bacterial infection. Thirty-four healthy and 131 sick cows were included. Procalcitonin concentrations were assessed using an ELISA kit for cattle. Depending on whether sick cows received antimicrobial treatments prior to admission or not, they were divided in treated (TP) or not treated (NTP) subgroups. Mann-Whitney U tests were performed to determine differences between healthy vs sick cows, while Kruskal-Wallis with Dunn's multiple comparison test were applied for healthy vs sick subgroups. Receiver operating characteristic (ROC) analysis was performed to assess the optimal cut-off value. Kaplan-Meier survival curves were determined for cows belonging to the groups with PCT values below and above ROC cut-offs. Plasma PCT concentration was 200.1 (147.8-324.1) pg/mL and 361.6 (239.7-947.1) pg/mL in the healthy control and in the sick group, respectively (P < 0.001). The optimal cut-off value of plasma PCT concentration was 244.4 pg/mL (sensitivity 73.6%, specificity 60.0%). The plasma PCT concentration was 267.5 (210.3-771.2) pg/mL in the TP subgroup and 425.6 (253.1-1242) pg/mL in the NTP subgroup (P = 0.03). Cows with PCT above the ROC cut-off value had a reduced survival percentage and a higher mortality risk (P < 0.05). Procalcitonin showed the ability of differentiate healthy cows from hospitalized cows with a conclusive diagnosis of inflammation due to bacterial infection. Moreover, PCT was a good predictor of negative prognostic outcome.
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Affiliation(s)
- Francesca Bonelli
- Department of Veterinary Sciences, University of Pisa, via Livornese s.n.c., San Piero a Grado 56122, Italy.
| | - Alessio Madrigali
- Department of Veterinary Sciences, University of Pisa, via Livornese s.n.c., San Piero a Grado 56122, Italy
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, via Livornese s.n.c., San Piero a Grado 56122, Italy
| | - Valentina Meucci
- Department of Veterinary Sciences, University of Pisa, via Livornese s.n.c., San Piero a Grado 56122, Italy
| | - Federica Battaglia
- Department of Veterinary Sciences, University of Pisa, via Livornese s.n.c., San Piero a Grado 56122, Italy
| | - Monika Guélat-Brechbuehl
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109a, Bern 3012, Switzerland
| | - Giulia Sala
- Department of Veterinary Medicine and Animal Science, University of Milan, Via dell'Università 6, Lodi, 26900, Italy
| | - Mireille Meylan
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bremgartenstrasse 109a, Bern 3012, Switzerland
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Hoeberg E, Sånge A, Saegerman C, Bohlin A, Nostell K, Durie I, Husted L, Öhman A, Jacobsen S, Berg L, Laursen SH, van Galen G. Serum amyloid A as a marker to detect sepsis and predict outcome in hospitalized neonatal foals. Vet Med (Auckl) 2022; 36:2245-2253. [PMID: 36239317 DOI: 10.1111/jvim.16550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Serum amyloid A (SAA) has been reported to hold promise as diagnostic and prognostic marker in foals. This has not been investigated thoroughly. OBJECTIVES Evaluate admission SAA concentrations as predictor of sepsis and outcome. ANIMALS Five hundred and ninety hospitalized foals <14 days old. METHODS Retrospective multicenter study. Foals were scored with sepsis and survival scores, grouped according to health category (septic, sick but nonseptic, uncertain sepsis status) and outcome; septic foals were further categorized according to severity (normal sepsis, severe sepsis, and septic shock). SAA was compared between groups using Mann-Whitney test and Kruskal-Wallis test. Receiver operating characteristic curves identified optimal SAA cut off values for detecting sepsis and predicting outcome. RESULTS Admission SAA concentrations differed significantly between sick nonseptic foals (312.1 ± 685.4 mg/L) and septic foals (1079.7 ± 1254.5 mg/L) and increased with increasing sepsis score. SAA did not differ between sepsis severity groups. The optimal cut off for sepsis detection was 1050 mg/L (sensitivity 30.2%, specificity 90.7%). Admission SAA concentrations were lower in surviving (435.0 ± 723.6 mg/L) compared to nonsurviving foals (1062.7 ± 1440.1 mg/L) and decreased with increasing survival score. The optimal cut off for nonsurvival prediction was 1250 mg/L (sensitivity 22.1%, specificity 90.8%). CONCLUSIONS AND CLINICAL IMPORTANCE SAA concentration was higher in septic foals and nonsurviving foals. Even though optimal cut offs for SAA to detect sepsis and predict outcome had low sensitivity, they had good specificity. SAA can therefore be used as a marker to rule out sepsis and nonsurvival.
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Affiliation(s)
- Emma Hoeberg
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Alexandra Sånge
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Claude Saegerman
- Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiege), Fundamental and Applied Research for Animal Health (FARAH) Center, Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Anna Bohlin
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | | | - Inge Durie
- Evidensia Equine Specialist Hospital Stromsholm, Stromsholm, Sweden
| | | | - Anna Öhman
- Evidensia Equine Specialist Hospital Helsingborg, Helsingborg, Sweden
| | - Stine Jacobsen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Lise Berg
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Sigrid Hyldahl Laursen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Equine Medical Consult, Hornbaek, Denmark
| | - Gaby van Galen
- Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.,Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Sydney, Australia
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6
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Long A. Clinical insights: Clinicopathological parameters for diagnosing and predicting outcome of horses with colic. Equine Vet J 2022; 54:1005-1010. [PMID: 36044554 DOI: 10.1111/evj.13871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Alicia Long
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
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7
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Biomarkers of sepsis in pigs, horses and cattle: from acute phase proteins to procalcitonin. Anim Health Res Rev 2022; 23:82-99. [PMID: 35795920 DOI: 10.1017/s1466252322000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Sepsis is a complex clinical syndrome triggered by an inflammatory host response to an infection. It is usually complicated to detect and diagnose, and has severe consequences in human and veterinary health, especially when treatment is not started early. Therefore, efforts to detect sepsis accurately are needed. In addition, its proper diagnosis could reduce the misuse of antibiotics, which is essential fighting against antimicrobial resistance. This case is a particular issue in farm animals, as antibiotics have been traditionally given massively, but now they are becoming increasingly restricted. When sepsis is suspected in animals, the most frequently used biomarkers are acute phase proteins such as C-reactive protein, serum amyloid A and haptoglobin, but their concentrations can increase in other inflammatory conditions. In human patients, the most promising biomarkers to detect sepsis are currently procalcitonin and presepsin, and there is a wide range of other biomarkers under study. However, there is little information on the application of these biomarkers in veterinary species. This review aims to describe the general concepts of sepsis and the current knowledge about the biomarkers of sepsis in pigs, horses, and cattle and to discuss possible advances in the field.
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8
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Meucci V, Orsetti C, Sgorbini M, Battaglia F, Cresci M, Bonelli F. Can Procalcitonin Be Dosed in Bovine Milk Using a Commercial ELISA Kit? Animals (Basel) 2022; 12:ani12030289. [PMID: 35158613 PMCID: PMC8833620 DOI: 10.3390/ani12030289] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Mastitis is one of the major economic and animal welfare problems on dairy farms. The gold standard test for mastitis diagnosis is milk culture, but bacteria are not always isolated (only in 11–44% of milk samples from clinical cases of mastitis) and sometimes a positive culture can result from a contamination of the milk. Procalcitonin is a new biomarker which may lead to an early detection of inflammation due to bacterial infection. In humans, procalcitonin concentration has also been evaluated in milk in addition to plasma. The authors aimed to evaluate the possible application of a commercially available ELISA kit for bovine procalcitonin for the assessing of procalcitonin in bovine milk samples. Plasma and milk samples from cows with mastitis were collected to measure procalcitonin concentrations by using a bovine procalcitonin ELISA kit. Our results showed that the ELISA kit tested can be employed to assess bovine procalcitonin in plasma but not for analyzing milk samples. Abstract The aim was to evaluate the use of a bovine procalcitonin (PCT) ELISA kit (Cusabio, China) for assessing PCT in bovine milk samples. Validation was performed by using 10 plasma and corresponding milk samples from mastitic cows. The limit of detection (LOD) was calculated. The coefficient of variation (CV%) of the readings of five plasma samples measured five times in the same plate (intra-assay) and the CV% of the same five samples read five times in three separate plates was evaluated. Parallelism was determined by serial twofold dilutions of five plasma and corresponding milk samples. Milk samples were analyzed with and without centrifugation. Regarding plasma PCT, the method presented an inter- and intra-CV < 23.7% and parallelism had very good recovery values. The ELISA kit studied can measure bovine plasma PCT concentrations. The kit antibodies fail in binding PCT in milk samples because all centrifuged milk samples showed a lower LOD than blank samples. Only three uncentrifuged milk samples showed measurable PCT concentrations. Due to these results, the commercial ELISA kit investigated could not be employed for the detection of PCT in milk samples.
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Affiliation(s)
- Valentina Meucci
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
| | - Chiara Orsetti
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, Via Vecchia di Marina 6, 56122 Pisa, Italy
| | - Micaela Sgorbini
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, Via Vecchia di Marina 6, 56122 Pisa, Italy
| | - Federica Battaglia
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
| | - Marta Cresci
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
| | - Francesca Bonelli
- Department of Veterinary Science, University of Pisa, Via Livornese snc, 56122 Pisa, Italy; (V.M.); (C.O.); (M.S.); (F.B.); (M.C.)
- Centro di Ricerche Agro-Ambientali “E. Avanzi”, University of Pisa, Via Vecchia di Marina 6, 56122 Pisa, Italy
- Correspondence:
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9
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Evaluation of Plasmatic Procalcitonin in Healthy, and in Systemic Inflammatory Response Syndrome (SIRS) Negative or Positive Colic Horses. Animals (Basel) 2021; 11:ani11072015. [PMID: 34359143 PMCID: PMC8300415 DOI: 10.3390/ani11072015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/29/2022] Open
Abstract
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.
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10
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Isgren CM. Improving clinical outcomes via responsible antimicrobial use in horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13502] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- C. M. Isgren
- Department of Equine Clinical Science Faculty of Health & Life Sciences Institute of Infection, Veterinary and Ecological Sciences University of Liverpool Leahurst UK
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11
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Cho JG, Oh YI, Song KH, Seo KW. Evaluation and comparison of serum procalcitonin and heparin-binding protein levels as biomarkers of bacterial infection in cats. J Feline Med Surg 2021; 23:370-374. [PMID: 33034249 PMCID: PMC10812220 DOI: 10.1177/1098612x20959973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES As bacterial infection can lead to sepsis and high mortality, early and easy diagnosis of sepsis can improve survival. In cats, the diagnosis of systemic bacterial infection is quite challenging, and, usually, non-specific markers for inflammation are employed. In humans, procalcitonin, heparin-binding protein and absolute neutrophil count are biomarkers that are studied in bacterial infections and sepsis owing to their high sensitivity and specificity. METHODS A total of 56 cats were categorised into 16 healthy cats and 40 bacterially infected cats, diagnosed by various examinations. In all cats, serum procalcitonin and heparin-binding protein levels were measured using ELISA and an absolute neutrophil count was performed. RESULTS The median values of procalcitonin levels and absolute neutrophil count were significantly higher in the infection group than in the normal group, but heparin-binding protein levels were not. A procalcitonin level >366 pg/ml was a better biomarker of bacterial infection than heparin-binding protein and absolute neutrophil count (sensitivity: 67.5%; specificity: 93.8%). Procalcitonin was not correlated with heparin-binding protein (r = 0.213, P = 0.115) and absolute neutrophil count (r = 0.393, P = 0.003). CONCLUSIONS AND RELEVANCE High procalcitonin levels in cats were associated with bacterial infection. Hence, procalcitonin could be a valuable marker for diagnosing bacterial infections in cats.
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Affiliation(s)
- Jae-Geum Cho
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Ye-In Oh
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Kun-Ho Song
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Kyoung-Won Seo
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea
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12
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Li H, Chen J, Hu Y, Cai X, Zhang P. Elevated Serum C1q Levels in Children With Sepsis. Front Pediatr 2021; 9:619899. [PMID: 33981650 PMCID: PMC8109246 DOI: 10.3389/fped.2021.619899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/24/2021] [Indexed: 12/29/2022] Open
Abstract
Objective: To analyze the serum complement C1q levels in children with sepsis, and explore the suggestive effect of serum C1q levels on the condition of children with sepsis. Methods: The clinical and laboratory data of children with sepsis (n = 95) and healthy children (n = 71) in Renmin Hospital of Wuhan University from January 2019 to October 2019 were collected, and each index of the two groups was compared. Then we divided children with sepsis into three subgroups based on the Pediatric Critical Illness Score (PCIS): non-critical group, critical group, and extremely critical group. The serum C1q and PCT levels of the three subgroups were analyzed, and the correlation analysis was carried out between the levels of serum C1q and PCT levels as well as PCIS among children with sepsis. Finally, we analyzed the serum C1q levels of septic children infected by different pathogens. Results: The serum C1q levels of children with sepsis were significantly higher than those of healthy children (median 198.4 vs. 186.2 mg/L, P < 0.001). In the analysis of subgroups, the serum C1q levels of non-critical group, critical group, and extremely critical group septic children were 182.80 (166.75, 195.85) mg/L, 219.90 (209.10, 246.40) mg/L and 249.95 (239.10, 272.25) mg/L, respectively, which were correlated with the severity of the disease. At the same time, we also found that serum C1q in children with sepsis was positively correlated with PCT levels (r = 0.5982, P < 0.001), and negatively correlated with PCIS score (r = -0.6607, P < 0.001). The serum C1q levels of septic children with bacterial infections, mycoplasma infections, viral infections, and co-infection were higher than those of the control group (P < 0.05). Conclusion: The serum levels of C1q in children with sepsis were increased and related to the severity of sepsis, suggesting that C1q may be involved in the occurrence and development of sepsis, which had reference value for the preliminary diagnosis and severity classification of sepsis.
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Affiliation(s)
- Huan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Juanjuan Chen
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuanhui Hu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Cai
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Pingan Zhang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
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Vitale V, Conte G, Baragli P, Jose-Cunilleras E, Sgorbini M. Heart rate variability in newborn foals and its association with illness: a pilot study. ITALIAN JOURNAL OF ANIMAL SCIENCE 2021. [DOI: 10.1080/1828051x.2021.1957724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Valentina Vitale
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
- Ospedale Didattico Veterinario “Mario Modenato”, University of Pisa, Pisa, Italy
| | - Giuseppe Conte
- Dipartimento di Scienze Agrarie, Alimentali e Agro-Alimentari, University of Pisa, Pisa, Italy
| | - Paolo Baragli
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
| | - Eduard Jose-Cunilleras
- Departament de Medicina i Cirurgia Animals, Autonomous University of Barcelona, Barcelona, Spain
| | - Micaela Sgorbini
- Dipartimento Scienze Veterinarie, University of Pisa, Pisa, Italy
- Ospedale Didattico Veterinario “Mario Modenato”, University of Pisa, Pisa, Italy
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Kilcoyne I, Nieto JE, Dechant JE. Diagnostic value of plasma and peritoneal fluid procalcitonin concentrations in horses with strangulating intestinal lesions. J Am Vet Med Assoc 2020; 256:927-933. [PMID: 32223710 DOI: 10.2460/javma.256.8.927] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the diagnostic value of plasma and peritoneal fluid procalcitonin concentrations for identification of horses with strangulating intestinal lesions. ANIMALS 65 horses with signs of colic of intestinal origin and 10 healthy (control) horses. PROCEDURES For each horse, plasma and peritoneal fluid samples were obtained for a CBC and determination of total protein, procalcitonin, and lactate concentrations. Signalment and clinicopathologic findings were compared among control horses and horses with strangulating and nonstrangulating intestinal lesions. RESULTS Mean ± SD plasma (274.9 ± 150.8 pg/mL) and peritoneal fluid (277 ± 50.6 pg/mL) procalcitonin concentrations for horses with colic were significantly greater than the mean ± SD plasma (175.5 ± 46.0 pg/mL) and peritoneal fluid (218.8 ± 48.7 pg/mL) procalcitonin concentrations for control horses. Mean procalcitonin concentration in peritoneal fluid, but not plasma, differed significantly between horses with strangulating lesions and those with nonstrangulating lesions. A peritoneal fluid procalcitonin concentration ≥ 281.7 pg/mL had a sensitivity of 81%, specificity of 69%, positive predictive value of 56.7%, and negative predictive value of 87.9% for detection of strangulating lesions. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that peritoneal fluid procalcitonin concentration, when evaluated in conjunction with other clinicopathologic results, might be a sensitive indicator of intestinal ischemia and facilitate early identification of horses that require surgery to address a strangulating lesion.
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Procalcitonin Detection in Veterinary Species: Investigation of Commercial ELISA Kits. Animals (Basel) 2020; 10:ani10091511. [PMID: 32859059 PMCID: PMC7552142 DOI: 10.3390/ani10091511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022] Open
Abstract
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.
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Vitale V, Sgorbini M, Cuteri V, Preziuso S, Attili AR, Bonelli F. Cytological Findings in Bronchoalveolar Lavage Fluid of Foals With Pneumonia Caused by Rhodococcus equi and Other Bacteria. J Equine Vet Sci 2019; 79:9-12. [PMID: 31405508 DOI: 10.1016/j.jevs.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 11/29/2022]
Abstract
The distinction between lower respiratory tract infections caused by Rhodococcus equi and those caused by other pathogens is difficult. The aim of this retrospective study was to describe cytological findings in bronchoalveolar lavage fluid (BALF) of foals with pneumonia caused by R. equi or other bacteria. Nineteen foals aged from 3 weeks to 6 months with evidence of respiratory disease between 2015 and 2016 were selected from the database of the Veterinary Teaching Hospital "Mario Modenato" of the University of Pisa. Eight foals of 19 (42.1%) had R. equi pneumonia, whereas 11 of 19 (57.9%) had another bacterial pneumonia. R. equi-positive foals had statistically significant higher total nucleated cell count (P = .02) and neutrophils percentage (P = .002) than R. equi-negative ones. Macrophages proportion (P = .01) was lower in R. equi-positive than in R. equi-negative foals. Bronchoalveolar lavage is a quite easy procedure that can be performed in the field with minimal equipment required. Here we reported significant differences in the cellular composition of BALF that can be used to differentiate foals with R. equi bronchopneumonia from those with other bacterial pneumonias, whereas waiting for culture results.
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Affiliation(s)
- Valentina Vitale
- University Veterinary Teaching Hospital, Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia
| | | | - Vincenzo Cuteri
- Infectious Diseases Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica MC, Italy
| | - Silvia Preziuso
- Infectious Diseases Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica MC, Italy
| | - Anna Rita Attili
- Infectious Diseases Laboratory, School of Biosciences and Veterinary Medicine, University of Camerino, Matelica MC, Italy
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Bonelli F, Meucci V, Divers TJ, Boccardo A, Pravettoni D, Meylan M, Belloli AG, Sgorbini M. Plasma procalcitonin concentration in healthy calves and those with septic systemic inflammatory response syndrome. Vet J 2018; 234:61-65. [PMID: 29680395 DOI: 10.1016/j.tvjl.2018.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 02/06/2018] [Accepted: 02/09/2018] [Indexed: 10/18/2022]
Abstract
The diagnosis of sepsis in calves is challenging. Blood culture and clinical signs combined with a complete blood count have been used for the diagnosis of sepsis. Recent literature in humans and animal species has been focused on sepsis-specific biomarkers, such as procalcitonin (PCT), that may more accurately and efficiently diagnose sepsis. The aim of this study was to evaluate plasma PCT concentrations in healthy and septic calves. Twenty healthy control calves and 58 sick calves with septic systemic inflammatory response syndrome (SIRS) based on SIRS score and clinical findings were included. Calves with septic SIRS were further divided in septic SIRS survivors (SSS) and non-survivors (SSNS). Plasma PCT concentrations were measured with a commercial ELISA assay for cattle. A receiver operating characteristic curve was used to determine cut-off values and corresponding sensitivity and specificity for the diagnosis of sepsis. Differences in plasma PCT concentration between groups (control vs. SSS vs. SSNS) were evaluated. Plasma PCT concentrations in healthy calves and those with septic SIRS were 33.3pg/mL (0-44.3pg/mL) and 166.5pg/mL (85.9-233.0pg/mL), respectively (P<0.001). The optimal cut-off value to predict septic SIRS was 67.39pg/mL (81.0% sensitivity, 95.0% specificity). Plasma PCT concentrations were 127.4pg/mL (72.2-216.0pg/mL) and 234.3pg/mL (204.5-309.4pg/mL) in the SSS and SSNS subgroups, respectively. Statistically significant differences were found among groups (control vs. SSS and SSNS, P<0.0001; SSS vs. SSNS, P>0.05). These results confirmed an increase in plasma PCT concentrations in calves with septic SIRS, as previously reported in humans and other species.
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Affiliation(s)
- F Bonelli
- Department of Veterinary Sciences, via Livornese snc, 56122, San Piero a Grado (PI), Italy.
| | - V Meucci
- Department of Veterinary Sciences, via Livornese snc, 56122, San Piero a Grado (PI), Italy
| | - T J Divers
- College of Veterinary Medicine, Cornell University, Vet Box 25, Ithaca, NY 14853, USA
| | - A Boccardo
- Department of Veterinary Medicine, via dell'Università 6, 26900, Lodi, Italy
| | - D Pravettoni
- Department of Veterinary Medicine, via dell'Università 6, 26900, Lodi, Italy
| | - M Meylan
- Clinic for Ruminants, Vetsuisse-Faculty, University of Bern, Bremgartenstrasse 109a, 3012 Bern, Switzerland
| | - A G Belloli
- Department of Veterinary Medicine, via dell'Università 6, 26900, Lodi, Italy
| | - M Sgorbini
- Department of Veterinary Sciences, via Livornese snc, 56122, San Piero a Grado (PI), Italy
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Bonelli F, Meucci V, Divers TJ, Wagner B, Intorre L, Sgorbini M. Kinetics of plasma procalcitonin, soluble CD14, CCL2 and IL-10 after a sublethal infusion of lipopolysaccharide in horses. Vet Immunol Immunopathol 2016; 184:29-35. [PMID: 28166929 DOI: 10.1016/j.vetimm.2016.12.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/08/2016] [Accepted: 12/22/2016] [Indexed: 01/12/2023]
Abstract
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.
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Affiliation(s)
- Francesca Bonelli
- The Department of Veterinary Sciences, University of Pisa (Bonelli, Intorre, Meucci, Sgorbini), 56122, San Piero a Grado (PI), Italy.
| | - Valentina Meucci
- The Department of Veterinary Sciences, University of Pisa (Bonelli, Intorre, Meucci, Sgorbini), 56122, San Piero a Grado (PI), Italy
| | - Thomas J Divers
- College of Veterinary Medicine, Cornell University (Wagner, Divers), Ithaca, NY 14853, United States
| | - Bettina Wagner
- College of Veterinary Medicine, Cornell University (Wagner, Divers), Ithaca, NY 14853, United States
| | - Luigi Intorre
- The Department of Veterinary Sciences, University of Pisa (Bonelli, Intorre, Meucci, Sgorbini), 56122, San Piero a Grado (PI), Italy
| | - Micaela Sgorbini
- The Department of Veterinary Sciences, University of Pisa (Bonelli, Intorre, Meucci, Sgorbini), 56122, San Piero a Grado (PI), Italy
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19
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Bonelli F, Meucci V, Divers TJ, Jose-Cunilleras E, Corazza M, Tognetti R, Guidi G, Intorre L, Sgorbini M. Plasma Procalcitonin Concentration in Healthy Horses and Horses Affected by Systemic Inflammatory Response Syndrome. J Vet Intern Med 2015; 29:1689-91. [PMID: 26474412 PMCID: PMC4895682 DOI: 10.1111/jvim.13640] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 07/30/2015] [Accepted: 09/10/2015] [Indexed: 01/29/2023] Open
Abstract
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.
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Affiliation(s)
- F Bonelli
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - V Meucci
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - T J Divers
- College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - E Jose-Cunilleras
- Department of Animal Medicine and Surgery, Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - M Corazza
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - R Tognetti
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - G Guidi
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - L Intorre
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
| | - M Sgorbini
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, PI, Italy
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