1
|
Renaud B, Kruse CJ, François AC, Cesarini C, van Loon G, Palmers K, Boemer F, Luis G, Gustin P, Votion DM. Large-scale study of blood markers in equine atypical myopathy reveals subclinical poisoning and advances in diagnostic and prognostic criteria. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2024; 110:104515. [PMID: 39032580 DOI: 10.1016/j.etap.2024.104515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/23/2024]
Abstract
Equine atypical myopathy (AM) is a severe rhabdomyolysis syndrome primarily caused by hypoglycin A (HGA) and methylenecyclopropylglycine protoxins. This study aimed to refine diagnostic and prognostic criteria for AM while exploring apparently healthy cograzers. Blood samples from 263 horses, including AM cases (n= 95), cograzers (n= 73), colic horses (n= 19), and controls (n= 76), were analyzed for HGA, its toxic metabolite, and acylcarnitines profile. Diseased horses exhibited alterations in acylcarnitines that strongly distinguished them from controls and colic horses. Regression analyses identified distinct acylcarnitines profiles among groups, with cograzers showing intermediate alterations. Age and gelding status emerged as protective factors against AM. Furthermore, serum acylcarnitines profiling was valuable in predicting AM survival, with isovaleryl-/2-methylbutyrylcarnitine (i.e., C5 acylcarnitine) showing promise as both a diagnostic and prognostic marker. Subclinical alterations in cograzers underscore a novel aspect: the presence of subclinical cases of AM.
Collapse
Affiliation(s)
- Benoît Renaud
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Caroline-J Kruse
- Department of Functional Sciences, Faculty of Veterinary Medicine, Physiology and Sport Medicine, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Anne-Christine François
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Carla Cesarini
- Equine Clinical Department, Faculty of Veterinary Medicine, Bât. B41, Sart Tilman, University of Liège, Liège 4000, Belgium.
| | - Gunther van Loon
- Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent 9820, Belgium.
| | | | - François Boemer
- Biochemical Genetics Laboratory, CHU Sart Tilman, University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Géraldine Luis
- Biochemical Genetics Laboratory, CHU Sart Tilman, University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Pascal Gustin
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| | - Dominique-Marie Votion
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, Liège 1 (Sart Tilman) 4000, Belgium.
| |
Collapse
|
2
|
Sander J, Terhardt M, Janzen N, Renaud B, Kruse CJ, François AC, Wouters CP, Boemer F, Votion DM. Tissue Specific Distribution and Activation of Sapindaceae Toxins in Horses Suffering from Atypical Myopathy. Animals (Basel) 2023; 13:2410. [PMID: 37570219 PMCID: PMC10417358 DOI: 10.3390/ani13152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Equine atypical myopathy is caused by hypoglycin A (HGA) and methylenecyclopropylglycine (MCPrG), the known protoxins of sycamore maple (Acer pseudoplatanus). Various tissues from five atypical myopathy cases were analyzed but only HGA was found. Whether deamination of MCPrG has already occurred in the intestine as the first stage of metabolization has not been investigated. Activation of the protoxins to methylenecyclopropylacetyl (MCPA)-CoA and methylenecyclopropylformyl (MCPF)-CoA, respectively, occurred mainly in the skeletal muscles, as evidenced by very high concentrations of MCPA-carnitine and MCPF-carnitine in this tissue. Inhibition of the acyl-CoA dehydrogenases of short- and medium-chain as well as branched-chain fatty acids by the toxins led to a strong increase in the corresponding acylcarnitines, again preferentially in skeletal muscles. An accumulation of the long-chain acylcarnitines beyond the level of the control samples could not be detected in the tissues. As a high amount of HGA was always found unmetabolized in the organs, we speculate that targeting the interruption of further metabolization might be a way to stop the progression of intoxication. Inhibition of the mitochondrial branched-chain amino acid aminotransferase, i.e., the first enzyme responsible for the activation of sycamore maple protoxins, could be a therapeutic approach.
Collapse
Affiliation(s)
- Johannes Sander
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
- Department of Clinical Chemistry, Hanover Medical School, 30625 Hanover, Germany
| | - Michael Terhardt
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
| | - Nils Janzen
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
- Department of Clinical Chemistry, Hanover Medical School, 30625 Hanover, Germany
| | - Benoît Renaud
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - Caroline-Julia Kruse
- Department of Functional Sciences, Physiology and Sport Medicine, Faculty of Veterinary Medicine, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium;
| | - Anne-Christine François
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - Clovis P. Wouters
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetics, CHU Sart Tilman, University of Liège, 4000 Liège, Belgium;
| | - Dominique-Marie Votion
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| |
Collapse
|
3
|
Sander J, Terhardt M, Janzen N. Severe Inhibition of Long-Chain Acyl-CoA Enoylhydratase (EC 4.2.1.74) in a Newborn Foal Suffering From Atypical Myopathy. Front Vet Sci 2021; 8:765623. [PMID: 34765670 PMCID: PMC8576321 DOI: 10.3389/fvets.2021.765623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
In horses, congenital defects of energy production from long-chain fatty acids have not been described so far. In contrast, inhibition of fatty acid degradation caused by the toxins hypoglycin A and methylenecyclopropylglycine from various maple species are observed frequently. These non-proteinogenic aminoacids are passed on placentally to fetuses or with collostrum or milk to newborn foals. Nevertheless, newborn foals become very rarely symptomatic. Vertical transmission apparently is not sufficient to induce clinical disease without a particular genetic constellation being present. One of these rare cases was investigated here using samples from a mare and her foal. Intoxication by hypoglycin A and methylenecyclopropylglycine is also of interest to human pathology, because these toxins have caused fatal poisonings after consumption of certain fruits many times, especially in children. Maple toxins, their metabolites and some short-chain acyl compounds were quantified by ultrahigh-pressure liquid chromatography/tandem mass spectrometry. An comprehensive spectrum of long-chain acylcarnitines was prepared using electrospray ionization tandem mass spectrometry. Organic acids and acylglycines were determined by gas chromatography mass spectrometry. For evaluation, results of other horses poisoned by maple material as well as unaffected control animals were used. In the serum of the foal, hypoglycin A was detected at a low concentration only. Toxin metabolites reached <3.5% of the mean of a comparison group of horses suffering from atypical myopathy. The spectrum of acylcarnitines indicated enzyme inhibition in short-chain and medium-chain regions typical of acer poisoning, but the measured concentrations did not exceed those previously found in clinically healthy animals after maple consumption. The values were not sufficient to explain the clinical symptoms. In contrast, a remarkably strong enrichment of tetradecenoylcarnitine and hexadecenoylcarnitine was observed. This proves a blockade of the long-chain enoyl-CoA hydratase (EC 4.2.1.74). Vertical transfer of maple toxins to a newborn foal is sufficient for induction of clinical disease only if there is an additional specific reactivity to the active toxins. This was found here in an inhibition of long-chain enoyl-CoA hydratase. Isolated dysfunction of this enzyme has not yet been reported in any species. Further studies are necessary to prove a specific genetic defect.
Collapse
Affiliation(s)
- Johannes Sander
- Screening-Labor Hannover, Hanover, Germany.,Hanover Medical School, Hanover, Germany
| | | | - Nils Janzen
- Screening-Labor Hannover, Hanover, Germany.,Hanover Medical School, Hanover, Germany
| |
Collapse
|
4
|
Sander J, Terhardt M, Janzen N. Study on the Metabolic Effects of Repeated Consumption of Canned Ackee. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2020; 68:14603-14609. [PMID: 33233889 DOI: 10.1021/acs.jafc.0c06235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Ackee fruits (Blighia sapida), an important food source in some tropical countries, can be the cause of serious poisoning. Ackees contain hypoglycin A and methylenecyclopropylglycine. Experiments were undertaken by a volunteer to elucidate the metabolic details of poisoning. Rapid intestinal absorption of the toxins was followed by their slow degradation to methylenecyclopropylacetyl and methylenecyclopropylformyl conjugates. Impairment of the metabolism of branched chain amino acids and ß-oxidation of fatty acids was found. Reduced enzyme activities were observed for several days after ingestion. A defined dose of fruit material caused significantly higher concentrations of metabolites when consumed 24 h after a previous ingestion than when consumed only once. The accumulation of toxins, toxin metabolites, and products of the intermediate metabolism after repeated consumption may, at least partly, explain the high frequency of fatal cases observed during harvesting. No inhibition of enzymes that degrade long-chain acyl compounds was observed in the experiments.
Collapse
Affiliation(s)
- Johannes Sander
- Screening-Labor Hannover, Postbox 91 10 09, 30430 Hannover, Germany
- Department of Hygiene, Hanover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | - Michael Terhardt
- Screening-Labor Hannover, Postbox 91 10 09, 30430 Hannover, Germany
| | - Nils Janzen
- Screening-Labor Hannover, Postbox 91 10 09, 30430 Hannover, Germany
- Department of Clinical Chemistry, Hanover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| |
Collapse
|
5
|
Votion DM, François AC, Kruse C, Renaud B, Farinelle A, Bouquieaux MC, Marcillaud-Pitel C, Gustin P. Answers to the Frequently Asked Questions Regarding Horse Feeding and Management Practices to Reduce the Risk of Atypical Myopathy. Animals (Basel) 2020; 10:ani10020365. [PMID: 32102384 PMCID: PMC7071031 DOI: 10.3390/ani10020365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Equine atypical myopathy is a severe intoxication of grazing equids resulting from the ingestion of samaras or seedlings of trees from the Acer species. The sycamore maple (Acer pseudoplatanus) is involved in European cases whereas the box elder (Acer negundo) is recognized as the cause of this seasonal pasture myopathy in the Unites States of America. In Europe, young and inactive animals with a thin to normal body condition and no feed supplementation, except for hay in autumn, are at higher risk. The risk is also associated with full time pasturing in a humid environment. Indeed, dead leaves piling up in autumn as well as, the presence of trees and/or woods presumably exposes the horses to the sycamore maple. This manuscript answers the most frequently asked questions arising from the equine field about feeding and management of equines to reduce the risk of atypical myopathy. All answers are based on data collected from 2006 to 2019 by the “Atypical Myopathy Alert Group” (AMAG, Belgium) and the “Réseau d’épidémiosurveillance en Pathologie équine” (RESPE, France) as well as on a review of the most recent literature. Abstract In 2014, atypical myopathy (AM) was linked to Acer pseudoplatanus (sycamore maple) in Europe. The emergence of this seasonal intoxication caused by a native tree has raised many questions. This manuscript aims at answering the five most frequently asked questions (FAQs) regarding (1) identification of toxic trees; reduction of risk at the level of (2) pastures and (3) equids; (4) the risk associated with pastures with sycamores that have always been used without horses being poisoned and (5) the length of the risk periods. Answers were found in a literature review and data gathered by AM surveillance networks. A guide is offered to differentiate common maple trees (FAQ1). In order to reduce the risk of AM at pasture level: Avoid humid pastures; permanent pasturing; spreading of manure for pasture with sycamores in the vicinity and avoid sycamore maple trees around pasture (FAQ2). To reduce the risk of AM at horse level: Reduce pasturing time according to weather conditions and to less than six hours a day during risk periods for horses on risk pasture; provide supplementary feeds including toxin-free forage; water from the distribution network; vitamins and a salt block (FAQ3). All pastures with a sycamore tree in the vicinity are at risk (FAQ4). Ninety-four percent of cases occur over two 3-month periods, starting in October and in March, for cases resulting from seeds and seedlings ingestion, respectively (FAQ5).
Collapse
Affiliation(s)
- Dominique-Marie Votion
- Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Lieège, 4000 Liège 1 (Sart Tilman), Belgium; (D.-M.V.); (M.-C.B.)
| | - Anne-Christine François
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
- Correspondence:
| | - Caroline Kruse
- Department of Functional Sciences, Faculty of Veterinary Medicine, Physiology and Sport Medicine, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium;
| | - Benoit Renaud
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
| | | | - Marie-Catherine Bouquieaux
- Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Lieège, 4000 Liège 1 (Sart Tilman), Belgium; (D.-M.V.); (M.-C.B.)
| | | | - Pascal Gustin
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
| |
Collapse
|
6
|
Fabius LS, Westermann CM. Evidence-based therapy for atypical myopathy in horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- L. S. Fabius
- Faculty of Veterinary Medicine; Utrecht University; Yalelaan Utrecht The Netherlands
| | - C. M. Westermann
- Faculty of Veterinary Medicine; Utrecht University; Yalelaan Utrecht The Netherlands
| |
Collapse
|
7
|
|
8
|
Karlíková R, Široká J, Jahn P, Friedecký D, Gardlo A, Janečková H, Hrdinová F, Drábková Z, Adam T. Equine atypical myopathy: A metabolic study. Vet J 2016; 216:125-32. [PMID: 27687939 DOI: 10.1016/j.tvjl.2016.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
Atypical myopathy (AM) is a potentially fatal disease of grazing horses. It is reportedly caused by the ingestion of sycamore seeds containing toxic hypoglycin A. In order to study metabolic changes, serum and urine samples from nine horses with atypical myopathy and 12 control samples from clinically healthy horses were collected and then analysed using a high-performance liquid chromatography coupled with tandem mass spectrometry; serum metabolic profiles as the disease progressed were also studied. Metabolic data were evaluated using unsupervised and supervised multivariate analyses. Significant differences were demonstrated in the concentrations of various glycine conjugates and acylcarnitines (C2-C26). Moreover, the concentrations of purine and pyrimidine metabolites, vitamins and their degradation products (riboflavin, trigonelline, pyridoxate, pantothenate), and selected organic and amino acids (aspartate, leucine, 2-oxoglutarate, etc.) were altered in horses with AM. These results represent a global view of altered metabolism in horses with atypical myopathy.
Collapse
Affiliation(s)
- R Karlíková
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic
| | - J Široká
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic.
| | - P Jahn
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - D Friedecký
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - A Gardlo
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Department of Mathematical Analysis and Applications of Mathematics, Palacký University, 17. listopadu 12, 771 46 Olomouc, Czech Republic
| | - H Janečková
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - F Hrdinová
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - Z Drábková
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - T Adam
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
| |
Collapse
|
9
|
Westermann CM, van Leeuwen R, van Raamsdonk LWD, Mol HGJ. Hypoglycin A Concentrations in Maple Tree Species in the Netherlands and the Occurrence of Atypical Myopathy in Horses. J Vet Intern Med 2016; 30:880-4. [PMID: 26995161 PMCID: PMC4913566 DOI: 10.1111/jvim.13927] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/15/2016] [Accepted: 02/18/2016] [Indexed: 11/28/2022] Open
Abstract
Background Atypical myopathy (AM) in horses is caused by the plant toxin hypoglycin A, which in Europe typically is found in the sycamore maple tree (Acer pseudoplatanus). Owners are concerned about whether their horses are in danger if they graze near maple trees. Hypothesis/Objectives To measure hypoglycin A in the most common maple tree species in the Netherlands, and to determine whether concentration of toxin is a predictor of AM in horses. Methods A total of 278 samples of maple tree leaves, sprouts, and seeds were classified by species. Mean concentrations of hypoglycin A were compared for the type of sample, the season and the occurrence of AM in the pasture (non‐AM versus AM). Statistical analysis was performed using generalized a linear model (SPPS22). Results Almost all Acer pseudoplatanus samples contained hypoglycin A, with concentrations differing significantly among sources (P < .001). Concentrations were significantly higher in seeds from the AM group than in seeds from the non‐AM group (856 ± 677 and 456 ± 358 mg/kg, respectively; P = .039). In sprouts and leaves this was not the case. Acer platanoides and Acer campestre samples did not contain detectable concentrations of hypoglycin A. Conclusions and clinical importance Acer platanoides and campestre seem to be safe around paddocks and pastures, whereas almost all Acer pseudoplatanus samples contained hypoglycin A. In all AM cases, Acer pseudoplatanus was found. Despite significantly higher concentration of hypoglycin A in seeds of pastures where AM has occurred, individual prediction of AM cannot be made by measuring these concentrations because of the high standard deviation.
Collapse
Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | | | | | - H G J Mol
- RIKILT-Wageningen UR, Wageningen, the Netherlands
| |
Collapse
|
10
|
Peters LWE, Smiet E, de Sain-van der Velden MGM, van der Kolk JH. Acylcarnitine ester utilization by the hindlimb of warmblood horses at rest and following low intensity exercise and carnitine supplementation. Vet Q 2015; 35:76-81. [PMID: 25831401 DOI: 10.1080/01652176.2015.1027039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Acylcarnitines play an important role in fuel metabolism in skeletal muscle. OBJECTIVE To assess acylcarnitine ester utilization by the hindlimb of horses at rest and following low intensity exercise and carnitine supplementation. ANIMALS AND METHODS Acylcarnitine ester uptake by the hindlimb was investigated using the arteriovenous difference technique. Blood from six warmblood mares (mean age 12 ± 3 (SD) years and weighing 538 ± 39 kg) was collected simultaneously from the transverse facial artery and from the caudal vena cava. Food was withheld for 12 hours prior to exercise. Exercise comprised a standardized treadmill protocol consisting of 5 minutes of walk, 20 minutes of trot and thereafter another 5 minutes of walk. At the end of the first exercise day, three horses were given carnitine supplementation (100 mg/kg bodyweight), whereas the other horses received saline. The next day the exercise was repeated and blood samples collected similarly. Free carnitine and acylcarnitines were analyzed as their butyl ester derivatives in heparinized plasma by electrospray tandem mass spectrometry. Statistical analysis was performed using a general linear mixed model. RESULTS C3-carnitine, C6-carnitine and C14:1-carnitine showed the largest average extraction by the hindlimb at rest and C3-carnitine, C5:1-carnitine and C16-carnitine immediately after low-intensity exercise. Carnitine supplementation significantly increased free carnitine, C5-carnitine and C8-carnitine extraction. CONCLUSION Carnitine supplementation altered the extraction of acylcarnitines by the hindlimb in horses exercising at low intensity. CLINICAL IMPORTANCE Findings might aid in optimizing performance and myopathy prevention of the equine athlete.
Collapse
|
11
|
Kranenburg L, Westermann C, de Sain-van der Velden M, de Graaf-Roelfsema E, Buyse J, Janssens G, van den Broek J, van der Kolk J. The effect of long-term oral L-carnitine administration on insulin sensitivity, glucose disposal, plasma concentrations of leptin and acylcarnitines, and urinary acylcarnitine excretion in warmblood horses. Vet Q 2014; 34:85-91. [DOI: 10.1080/01652176.2014.919745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
|
12
|
Votion DM. The story of equine atypical myopathy: a review from the beginning to a possible end. ISRN VETERINARY SCIENCE 2012; 2012:281018. [PMID: 23762581 PMCID: PMC3671727 DOI: 10.5402/2012/281018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 09/25/2012] [Indexed: 11/23/2022]
Abstract
Atypical myopathy (AM) is a frequently fatal seasonal pasture myopathy that emerges in Europe. Outbreaks are of an acute and unexpected nature and practitioners should be prepared to handle these critically ill patients. This review retraces the history of AM and describes results of epidemiological investigations that were conducted to raise hypotheses concerning the etiology of this devastating disease as well as to be able to suggest potential preventive measures. Also, clinical studies have contributed to a better definition and recognition of the syndrome, whereas elucidation of the pathological process, identified as a multiple acyl-CoA dehydrogenase deficiency (MADD), was a great step forward improving medical management of AM and guiding the search for the etiological agent towards toxins that reproduce the identified defect. Treatment plans can be extrapolated from the described clinical signs and metabolic problems, but they remain limited to supportive care until the causative agent has been identified with certainty. Since treatment is still unsuccessful in the majority of cases, the main emphasis is currently still on prevention. This paper aims at being a practical support for equine clinicians dealing with AM and is based on discussion and comparison of the currently available scientific data.
Collapse
Affiliation(s)
- Dominique-Marie Votion
- Equine Clinic, Faculty of Veterinary Medicine, University of Liege, Boulevard de Colonster 20 B41, 4000 Liege, Belgium
| |
Collapse
|
13
|
van Galen G, Votion DM. Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: First aid, cardiovascular, nutritional and digestive care. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00439.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Westermann CM, Dorland L, van Diggelen OP, Schoonderwoerd K, Bierau J, Waterham HR, van der Kolk JH. Decreased oxidative phosphorylation and PGAM deficiency in horses suffering from atypical myopathy associated with acquired MADD. Mol Genet Metab 2011; 104:273-8. [PMID: 21843962 DOI: 10.1016/j.ymgme.2011.07.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 07/21/2011] [Indexed: 11/27/2022]
Abstract
Earlier research on ten horses suffering from the frequently fatal disorder atypical myopathy showed that MADD (multiple acyl-CoA dehydrogenase deficiency) is the biochemical derangement behind atypical myopathy. From five horses that died as a result of this disease and seven healthy control horses, urine and plasma were collected ante mortem and muscle biopsies were obtained immediately post-mortem (2 patients and 7 control horses), to analyse creatine, purine and carbohydrate metabolism as well as oxidative phosphorylation. In patients, the mean creatine concentration in urine was increased 17-fold and the concentration of uric acid approximately 4-fold, compared to controls. The highest degree of depletion of glycogen was observed in the patient with the most severe myopathy clinically. In this patient, glycolysis was more active than in the other patients and controls, which may explain this depletion. One patient demonstrated very low phosphoglycerate mutase (PGAM) activity, less than 10% of reference values. Most respiratory chain complex activity in patients was 20-30% lower than in control horses, complex II activity was 42% lower than normal, and one patient had severely decrease ATP-synthase activity, more than 60% lower than in control horses. General markers for myopathic damage are creatine kinase (CK) and lactic acid in plasma, and creatine and uric acid in urine. To obtain more information about the cause of the myopathy analysis of carbohydrate, lipid and protein metabolism as well as oxidative phosphorylation is advised. This study expands the diagnostic possibilities of equine myopathies.
Collapse
Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Medicine Section, Faculty of Veterinary Medicine, Yalelaan 114, 3584 CM, Utrecht University, Utrecht, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
15
|
Izumi R, Suzuki N, Nagata M, Hasegawa T, Abe Y, Saito Y, Mochizuki H, Tateyama M, Aoki M. A case of late onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency manifesting as recurrent rhabdomyolysis and acute renal failure. Intern Med 2011; 50:2663-8. [PMID: 22041377 DOI: 10.2169/internalmedicine.50.5172] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report an adult case of late-onset riboflavin-responsive multiple acyl-CoA dehydrogenase deficiency (MADD) characterized by episodic recurrent rhabdomyolysis and acute renal failure after the age of 46. Muscle biopsy revealed lipid storage myopathy and the finding of serum acylcarnitine and urine organic acid analyses were consistent with MADD. A compound heterozygous mutation was identified in the electron-transferring-flavoprotein dehydrogenase (ETFDH) gene, including a novel missense mutation, which confirmed the diagnosis of MADD. After administration of riboflavin and L-carnitine, the muscle weakness and fatigability gradually improved. Acylcarnitine and urine organic acid were also normalized after supplementation. Thus, MADD should be included in one of the differential diagnoses for adult recurrent rhabdomyolysis. Gene analysis is useful to confirm the diagnosis, and early diagnosis is important because riboflavin treatment has been effective in a significant number of patients with MADD.
Collapse
Affiliation(s)
- Rumiko Izumi
- Department of Neurology, Tohoku University School of Medicine, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
The electron transfer flavoprotein: ubiquinone oxidoreductases. BIOCHIMICA ET BIOPHYSICA ACTA-BIOENERGETICS 2010; 1797:1910-6. [PMID: 20937244 DOI: 10.1016/j.bbabio.2010.10.007] [Citation(s) in RCA: 162] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 07/20/2010] [Accepted: 10/05/2010] [Indexed: 12/30/2022]
Abstract
Electron transfer flavoprotein: ubiqionone oxidoreductase (ETF-QO) is a component of the mitochondrial respiratory chain that together with electron transfer flavoprotein (ETF) forms a short pathway that transfers electrons from 11 different mitochondrial flavoprotein dehydrogenases to the ubiquinone pool. The X-ray structure of the pig liver enzyme has been solved in the presence and absence of a bound ubiquinone. This structure reveals ETF-QO to be a monotopic membrane protein with the cofactors, FAD and a [4Fe-4S](+1+2) cluster, organised to suggests that it is the flavin that serves as the immediate reductant of ubiquinone. ETF-QO is very highly conserved in evolution and the recombinant enzyme from the bacterium Rhodobacter sphaeroides has allowed the mutational analysis of a number of residues that the structure suggested are involved in modulating the reduction potential of the cofactors. These experiments, together with the spectroscopic measurement of the distances between the cofactors in solution have confirmed the intramolecular pathway of electron transfer from ETF to ubiquinone. This approach can be extended as the R. sphaeroides ETF-QO provides a template for investigating the mechanistic consequences of single amino acid substitutions of conserved residues that are associated with a mild and late onset variant of the metabolic disease multiple acyl-CoA dehydrogenase deficiency (MADD).
Collapse
|
17
|
van der Kolk JH, Wijnberg ID, Westermann CM, Dorland L, de Sain-van der Velden MGM, Kranenburg LC, Duran M, Dijkstra JA, van der Lugt JJ, Wanders RJA, Gruys E. Equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) in 14 horses associated with ingestion of Maple leaves (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum). Mol Genet Metab 2010; 101:289-91. [PMID: 20655779 DOI: 10.1016/j.ymgme.2010.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 06/27/2010] [Accepted: 06/27/2010] [Indexed: 11/30/2022]
Abstract
This case-series describes fourteen horses suspected of equine acquired multiple acyl-CoA dehydrogenase deficiency (MADD) also known as atypical myopathy of which seven cases were confirmed biochemically with all horses having had access to leaves of the Maple tree (Acer pseudoplatanus) covered with European tar spot (Rhytisma acerinum). Assessment of organic acids, glycine conjugates, and acylcarnitines in urine was regarded as gold standard in the biochemical diagnosis of equine acquired multiple acyl-CoA dehydrogenase deficiency.
Collapse
Affiliation(s)
- J H van der Kolk
- Department of Equine Sciences, Medicine Section, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
El-Deeb WM, El-Bahr SM. Investigation of selected biochemical indicators of Equine Rhabdomyolysis in Arabian horses: pro-inflammatory cytokines and oxidative stress markers. Vet Res Commun 2010; 34:677-89. [PMID: 20830520 DOI: 10.1007/s11259-010-9439-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2010] [Indexed: 01/08/2023]
Abstract
A total of 30 horses were divided into two groups, one served as a control whereas other was rhabdomyolysis diseased horses. After blood collection, the resulted sera were used for estimation of the activities of creatin kinase (CK), aspartate transaminase (AST), lactate dehydrogenase (LDH), lactic acid, triacylglycerol (TAG), glucose, total protein, albumin, globulin, urea, creatinine, Triiodothyronine (T(3)), calcium, sodium, potassium, phosphorus, chloride, vitamin E, interleukin-6 (IL-6) and tumor necrosis-α (TNF-α). In addition, whole blood was used for determination of selenium, reduced glutathione (G-SH) and prostaglandin F2-α (PGF2α). The erythrocyte hemolysates were used for the determination of the activities of super oxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), nitric oxide (NO) and malondialdehyde (MDA). The present findings revealed a significant (p ≤ 0.05) increase in the values of CK, AST, LDH, glucose, lactate, TAG, urea, creatinine, phosphorus, MDA, TNF- α, IL6 and PGF2- α in diseased horses when compared with the control. Furthermore, the values of calcium, SOD, CAT, TAC, NO and GSH in diseased horses were significantly (p ≤ 0.05) lower than the control. The other examined parameters were not statistically significant. In conclusion, the examined pro-inflammatory cytokines were useful biomarkers for the diagnosis of Equine rhabdomyolysis (ER) in Arabian horses beside the old examined biomarkers. In the future, efforts should be made to confirm this in other breed. If this could be achieved, it would open up new perspectives in research fields dealing with ER.
Collapse
Affiliation(s)
- Wael Mohamed El-Deeb
- Department of clinical studies, College of Veterinary Medicine and animal Resources, King Faisal University, P.O. Box: 1757, Al-Ahsa, 31982, Saudi Arabia.
| | | |
Collapse
|
19
|
Novel markers for tying-up in horses by proteomics analysis of equine muscle biopsies. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY D-GENOMICS & PROTEOMICS 2010; 5:178-83. [DOI: 10.1016/j.cbd.2010.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/26/2010] [Accepted: 03/30/2010] [Indexed: 11/20/2022]
|
20
|
Current world literature. Curr Opin Rheumatol 2008; 20:729-35. [PMID: 18946335 DOI: 10.1097/bor.0b013e328317a234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Current world literature. Curr Opin Neurol 2008; 21:615-24. [PMID: 18769258 DOI: 10.1097/wco.0b013e32830fb782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Westermann CM, Dorland L, Votion DM, de Sain-van der Velden MGM, Wijnberg ID, Wanders RJA, Spliet WGM, Testerink N, Berger R, Ruiter JPN, van der Kolk JH. Acquired multiple Acyl-CoA dehydrogenase deficiency in 10 horses with atypical myopathy. Neuromuscul Disord 2008; 18:355-64. [PMID: 18406615 DOI: 10.1016/j.nmd.2008.02.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 02/07/2008] [Accepted: 02/18/2008] [Indexed: 11/29/2022]
Abstract
The aim of the current study was to assess lipid metabolism in horses with atypical myopathy. Urine samples from 10 cases were subjected to analysis of organic acids, glycine conjugates, and acylcarnitines revealing increased mean excretion of lactic acid, ethylmalonic acid, 2-methylsuccinic acid, butyrylglycine, (iso)valerylglycine, hexanoylglycine, free carnitine, C2-, C3-, C4-, C5-, C6-, C8-, C8:1-, C10:1-, and C10:2-carnitine as compared with 15 control horses (12 healthy and three with acute myopathy due to other causes). Analysis of plasma revealed similar results for these predominantly short-chain acylcarnitines. Furthermore, measurement of dehydrogenase activities in lateral vastus muscle from one horse with atypical myopathy indeed showed deficiencies of short-chain acyl-CoA dehydrogenase (0.66 as compared with 2.27 and 2.48 in two controls), medium-chain acyl-CoA dehydrogenase (0.36 as compared with 4.31 and 4.82 in two controls) and isovaleryl-CoA dehydrogenase (0.74 as compared with 1.43 and 1.61 nmol min(-1) mg(-1) in two controls). A deficiency of several mitochondrial dehydrogenases that utilize flavin adenine dinucleotide as cofactor including the acyl-CoA dehydrogenases of fatty acid beta-oxidation, and enzymes that degrade the CoA-esters of glutaric acid, isovaleric acid, 2-methylbutyric acid, isobutyric acid, and sarcosine was suspected in 10 out of 10 cases as the possible etiology for a highly fatal and prevalent toxic equine muscle disease similar to the combined metabolic derangements seen in human multiple acyl-CoA dehydrogenase deficiency also known as glutaric acidemia type II.
Collapse
Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Medicine Section, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3508 TD Utrecht, The Netherlands
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Equine atypical myopathy: a review. Vet J 2008; 178:185-90. [PMID: 18375157 DOI: 10.1016/j.tvjl.2008.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 02/01/2008] [Accepted: 02/08/2008] [Indexed: 11/21/2022]
Abstract
Atypical myopathy (AM) is an acute rhabdomyolysis syndrome that occurs at irregular intervals in grazing equines. An increasing number of outbreaks have been reported in recent years, including some from countries where the disease has not previously been diagnosed. In this review, clinical and other details of outbreaks of AM are analysed to better define its epidemiological profile. Potential aetiologies are discussed, the short clinical course of AM is described and the main biochemical and pathological findings are considered. Recommendations for medical management are suggested, based on a review of clinical reports. Biochemical and histopathological findings have been integrated in order to characterise the physiopathology of AM. There is an ongoing requirement to record new cases of this syndrome, ideally through an epidemiological network.
Collapse
|