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Lv H, Wang Q, Liu F, Jin L, Ren P, Li L. A biochemical feedback signal for hypothermia treatment for neonatal hypoxic-ischemic encephalopathy: focusing on central nervous system proteins in biofluids. Front Pediatr 2024; 12:1288853. [PMID: 38766393 PMCID: PMC11100326 DOI: 10.3389/fped.2024.1288853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Hypothermia has been widely used to treat moderate to severe neonatal hypoxic-ischemic encephalopathy (HIE), yet evaluating the effects of hypothermia relies on clinical neurology, neuroimaging, amplitude-integrated electroencephalography, and follow-up data on patient outcomes. Biomarkers of brain injury have been considered for estimating the effects of hypothermia. Proteins specific to the central nervous system (CNS) are components of nervous tissue, and once the CNS is damaged, these proteins are released into biofluids (cerebrospinal fluid, blood, urine, tears, saliva), and they can be used as markers of brain damage. Clinical reports have shown that CNS-specific marker proteins (CNSPs) were early expressed in biofluids after brain damage and formed unique biochemical profiles. As a result, these markers may serve as an indicator for screening brain injury in infants, monitoring disease progression, identifying damage region of brain, and assessing the efficacy of neuroprotective measures. In clinical work, we have found that there are few reports on using CNSPs as biological signals in hypothermia for neonatal HIE. The aim of this article is to review the classification, origin, biochemical composition, and physiological function of CNSPs with changes in their expression levels after hypothermia for neonatal HIE. Hopefully, this review will improve the awareness of CNSPs among pediatricians, and encourage future studies exploring the mechanisms behind the effects of hypothermia on these CNSPs, in order to reduce the adverse outcome of neonatal HIE.
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Affiliation(s)
- Hongyan Lv
- Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
- Department of Neonatal Pathology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
| | - Qiuli Wang
- Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
| | - Fang Liu
- Department of Pediatrics, The 980 Hospital of the PLA Joint Logistics Support Force, Shijiazhuang, China
| | - Linhong Jin
- Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
| | - Pengshun Ren
- Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
| | - Lianxiang Li
- Department of Neonatal Pathology, Handan Maternal and Child Health Care Hospital, Handan, Hebei, China
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Uztimür M, Dörtbudak MB. Evaluation of brain injury in goats naturally infected with Coenurus cerebralis; brain specific biomarkers, acute inflammation, and DNA oxidation. Res Vet Sci 2023; 165:105043. [PMID: 37856943 DOI: 10.1016/j.rvsc.2023.105043] [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: 07/18/2023] [Revised: 09/14/2023] [Accepted: 10/01/2023] [Indexed: 10/21/2023]
Abstract
This investigate goals are to establish the utility of brain-specific biomarkers (GFAP and S100B) in vivo and to assess the brain damage in C. cerebralis-infected goats using histopathological and immunopathological methods. The animal material of the study consisted of 10 healthy and 20 Coenurus cerebralis infected female hair goats. Serum GFAP and S100B concentrations were measured to determine brain damage. Serum S100B (p < 0.037), GFAP (p < 0.012), urea (p < 0.045), GGT (p < 0.001) and ALT (p < 0.001) concentrations in the C.cerebralis group were significantly higher than the control group. There was no significant difference between the C.cerebralis group and the control group for hsTnI (p > 0.078), creatinine (p > 0.099) and CK-MB (p > 0.725). In the histopathological examination, pressure atrophy and related inflammatory changes were observed due to mechanical damage of the parasite. Immunohistochemical examinations revealed that the parasite stimulated inflammation with the expression of TNF-α and caused DNA damage with the expression of 8-OHdG. As a result, when the data collected for this study are assessed as a whole, it is thought that the use of brainspecific GFAP and S100B biomarkers may be beneficial in determining brain damage in naturally infected hair goats with C.cerebralis. Changes in the levels of brain-specific biomarkers contribute significantly to determining the prognosis of the disease in vivo. Measurement of GFAP and S100B concentrations from serum offers an important alternative to the CSF method.
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Affiliation(s)
- Murat Uztimür
- Bingöl University, Faculty of Veterinary Medicine, Department of Internal Medicine, Bingöl, Türkiye.
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Donnelly CG, Finno CJ. Vitamin E depletion is associated with subclinical axonal degeneration in juvenile horses. Equine Vet J 2023; 55:884-890. [PMID: 36516303 PMCID: PMC10264549 DOI: 10.1111/evj.13907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Phosphorylated neurofilament heavy, a marker of neuroaxonal damage, is increased in horses with equine neuroaxonal dystrophy. However, the temporal dynamics of this biomarker during the post-natal risk period are not understood. OBJECTIVE To measure serum and cerebrospinal fluid phosphorylated neurofilament heavy concentrations in juvenile foals across the post-natal window of susceptibility for equine neuroaxonal dystrophy. STUDY DESIGN Case-control in vivo experimental study. METHODS Concentrations of phosphorylated neurofilament heavy were measured using frozen serum and cerebrospinal fluid collected from 13 foals raised in a vitamin E deficient environment from 1 to 6 months of age. Four of these foals were produced by equine neuroaxonal dystrophy-affected dams, developed clinical signs consistent with equine neuroaxonal dystrophy and had a diagnosis confirmed by histopathology. The remaining nine foals, produced by healthy mares, were vitamin E depleted and remained clinically healthy. An additional cohort of foals, produced by healthy mares, were supplemented with vitamin E (α-tocopherol; α-TOH) from birth and sampled similarly. RESULTS Serum α-TOH concentrations were significantly higher in vitamin E supplemented healthy foals. Serum phosphorylated neurofilament heavy concentrations did not differ significantly between groups at any time point. Cerebrospinal fluid phosphorylated neurofilament heavy concentrations increased with age in healthy vitamin E depleted foals (p < 0.001); an effect that was not observed in healthy vitamin E supplemented foals. MAIN LIMITATIONS A genetically susceptible cohort supplemented with vitamin E was not available for comparison. CONCLUSION We demonstrate that vitamin E depletion may elevate cerebrospinal fluid phosphorylated neurofilament heavy in otherwise healthy juvenile foals by 6 months of age. We highlight an important cofactor to consider when interpreting cerebrospinal fluid phosphorylated neurofilament heavy concentrations in juvenile horses.
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Affiliation(s)
- Callum G. Donnelly
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Carrie J. Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA
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Ryan CA, Giguère S, Morresey PR. Plasma UCHL-1 as a Biomarker of Brain Injury in Hospitalized Foals With Neonatal Encephalopathy. J Equine Vet Sci 2023; 126:104490. [PMID: 37031927 DOI: 10.1016/j.jevs.2023.104490] [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: 01/06/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
A plasma biomarker such as ubiquitin carboxyl-terminal hydrolase L1 (UCHL-1) to distinguish neonatal encephalopathy (NE) from other disorders and provide prognostic information would be useful for equine practitioners. In this prospective study, plasma UCHL-1 was measured in 331 hospitalized foals ≤4 days of age. Clinical diagnoses of neonatal encephalopathy only (NE group, n = 77), sepsis only (Sepsis group, n = 34), concurrent sepsis and NE (NE+Sepsis group, n = 85), or neither sepsis nor NE (Other group, n = 101) were made by the attending veterinarian. Plasma UCHL-1 concentrations were measured by ELISA. Differences between clinical diagnoses groups were evaluated and receiver operator curve (ROC) analysis was performed to assess diagnostic and prognostic performance. Median admission UCHL-1 concentration was significantly higher for NE (18.22 ng/mL; 7.93-37.43) and NE+Sepsis (17.42 ng/mL; 7.67-36.24) groups than Other foals (7.77 ng/mL; 3.92-22.76). Admission UCHL-1 was significantly higher in nonsurvivors (16.66 ng/mL; 6.89-34.84) than survivors (10.27 ng/mL; 5.82-29.94). Overall diagnostic performance of admission UCHL-1 concentration for NE diagnosis was determined (AUC 0.61; 95% confidence interval [CI] = 0.55-0.68); sensitivity and specificity for predicting NE were 73% and 49% respectively. Overall prognostic performance of time to lowest UCHL-1 concentration for predicting nonsurvival was determined (AUC 0.72; 95% CI = 0.65-0.79); sensitivity and specificity were 86% and 43% respectively. In this foal population, differences in plasma UCHL-1 concentrations were observed between foals with NE or NE with sepsis, and other diagnoses. The diagnostic and prognostic value of admission UCHL-1 concentration was limited.
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Affiliation(s)
- Clare A Ryan
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA.
| | - Steeve Giguère
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Peter R Morresey
- Internal Medicine Service, The Rood & Riddle Equine Hospital, Lexington, KY
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Investigation of Potential Serum Biomarkers for the Diagnosis of Chronic Back Pain in Horses. MACEDONIAN VETERINARY REVIEW 2023. [DOI: 10.2478/macvetrev-2023-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Abstract
Back pain is one of the most common triggers of performance failure in athletic and riding horses. Diagnosis of equine back pain has been very challenging for equine practitioners, particularly in chronic cases. Therefore, the identification of blood biomarkers would facilitate the clinical differentiation of chronic back pain. This study aimed to investigate serum biomarkers of glial cell activation, axonal damage, and inflammation for the diagnosis of equine chronic back pain. Serum samples from forty horses comprising chronic back pain (CBP), back pain concurrent with lameness (BPL), lameness (LN), and healthy control (HC) (n=10 per group) were screened for ionized calcium-binding adaptor molecule 1 (Iba-1), glial fibrillary acidic protein (GFAP), phosphorylated neurofilament-H (pNF-H) by ELISA, and proinflammatory cytokines (IL-1β, IL-6, and TNF-α) by multiplex assay. Serum concentrations of GFAP (3.81±1.72 ng/mL) and pNF-H (0.76±0.18 ng/mL) were significantly (p<0.05) higher in horses with CBP when compared with other groups. Iba-1 was not significantly higher in CBP horses. There was no significant difference between the pro-inflammatory cytokines among the groups. The levels of IL-1β, IL-6, and TNF-α were also increased in the CBP than the HC control horses but lower in relation to BPL and LN horses. In addition, serum Iba-1, GFAP, and pNF-H showed a high discriminatory capacity for horses with CBP with high sensitivity (50-100%) and specificity (70-100%). This study provides evidence that serum levels of the GFAP and pNF-H may be useful in the clinical differentiation of horses with chronic back pain.
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The Usefulness of Serum Brain Damage Biomarkers in Detection and Evaluation of Hypoxic Ischemic Encephalopathy in Calves with Perinatal Asphyxia. Animals (Basel) 2022; 12:ani12223223. [PMID: 36428450 PMCID: PMC9686605 DOI: 10.3390/ani12223223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022] Open
Abstract
The purpose of the present study was to determine hypoxic brain damage in calves with perinatal asphyxia using brain-specific damage biomarkers. Ten healthy and 25 calves with perinatal asphyxia were enrolled in the study. Clinical examination, neurological status score, and laboratory analysis were performed at admission, 24, 48, and 72 h. Serum concentrations of ubiquitin carboxy-terminal hydrolysis 1 (UCHL1), calcium-binding protein B (S100B), adrenomodullin (ADM), activitin A (ACTA), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP) and creatine kinase-brain (CK-B) were measured. Histopathological and immunohistochemical examinations of the brain tissue were performed in 13 nonsurvivor calves. The neurological status score of the calves with asphyxia was significantly (p < 0.05) lower. Mix metabolic-respiratory acidosis and hypoxemia were detected in calves with asphyxia. Serum UCHL1 and S100B were significantly (p < 0.05) increased, and NSE, ACTA, ADM, and CK-B were decreased (p < 0.05) in calves with asphyxia. Histopathological and immunohistochemical examinations confirmed the development of mild to severe hypoxic-ischemic encephalopathy. In conclusion, asphyxia and hypoxemia caused hypoxic-ischemic encephalopathy in perinatal calves. UCHL1 and S100B concentrations were found to be useful markers for the determination of hypoxic-ischemic encephalopathy in calves with perinatal asphyxia. Neurological status scores and some blood gas parameters were helpful in mortality prediction.
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Study on NGF and VEGF during the Equine Perinatal Period-Part 2: Foals Affected by Neonatal Encephalopathy. Vet Sci 2022; 9:vetsci9090459. [PMID: 36136675 PMCID: PMC9503474 DOI: 10.3390/vetsci9090459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Neonatal Encephalopathy (NE) may be caused by hypoxic ischemic insults or inflammatory insults and modified by innate protective or excitatory mechanisms. Understanding the underlying pathophysiology is important in formulating a rational approach to diagnosis. The preliminary aim was to clinically characterize a population of foals spontaneously affected by NE. The study aimed to: (i) evaluate nerve growth factor (NGF) and vascular endothelial growth factor (VEGF) levels in plasma samples obtained in the affected population at parturition from the mare’s jugular vein, umbilical cord vein and foal’s jugular vein, as well as in amniotic fluid; (ii) evaluate the NGF and VEGF content in the plasma of foals affected by NE during the first 72 h of life/hospitalization; (iii) evaluate NGF and VEGF levels at birth/admission in relation to selected mare’s and foal’s clinical parameters; (iv) evaluate the relationship between the two trophic factors and thyroid hormone levels (TT3 and TT4) in the first 72 h of life/hospitalization; and (v) assess the mRNA expression of NGF, VEGF and brain-derived neurotrophic factor (BDNF), and their cell surface receptors, in the placenta of mares that delivered foals affected by NE. Thirteen affected foals born from mares hospitalized for peripartum monitoring (group NE) and twenty affected foals hospitalized after birth (group exNE) were included in the study. Dosage of NGF and VEGF levels was performed using commercial ELISA kits, whereas NGF, VEGF, and BDNF placental gene expression was performed using a semi-quantitative real-time PCR. In group NE, NGF levels decreased significantly from T0 to T24 (p = 0.0447) and VEGF levels decreased significantly from T0 to T72 (p = 0.0234), whereas in group exNE, only NGF levels decreased significantly from T0 to T24 (p = 0.0304). Compared to healthy foals, a significant reduction of TT3 levels was observed in both NE (T24, p = 0.0066; T72 p = 0.0003) and exNE (T0, p = 0.0082; T24, p < 0.0001; T72, p < 0.0001) groups, whereas a significant reduction of TT4 levels was observed only in exNE group (T0, p = 0.0003; T24, p = 0.0010; T72, p = 0.0110). In group NE, NGF levels were positively correlated with both TT3 (p = 0.0475; r = 0.3424) and TT4 levels (p = 0.0063; r = 0.4589). In the placenta, a reduced expression of NGF in the allantois (p = 0.0033) and a reduced expression of BDNF in the amnion (p = 0.0498) were observed. The less pronounced decrease of the two trophic factors compared to healthy foals, their relationship with thyroid hormones over time, and the reduced expression of NGF and BDNF in placental tissues of mares that delivered affected foals, could be key regulators in the mechanisms of equine NE.
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Furr MO. Neurologic Disorders of the Foal. Vet Clin North Am Equine Pract 2022; 38:283-297. [PMID: 35811202 DOI: 10.1016/j.cveq.2022.05.005] [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] [Indexed: 11/19/2022] Open
Abstract
Neurologic disease of foals is a diagnostic and therapeutic challenge for veterinarians. Disease conditions such as neonatal encephalopathy are seen as well as developmental and congenital defects, bacterial infections, and trauma. Neonatal encephalopathy can be considered a "syndrome" with a variety of causes resulting in a similar clinical presentation. These causes can be categorized as maladaptation, hypoxic/ischemic encephalopathy, and metabolic abnormalities, all leading to signs of cerebral and brainstem disease. Spinal cord signs may occasionally be seen, but these signs are usually overshadowed by cerebral disease. Treatment in most cases involves supportive care and outcome is favorable in most cases.
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Affiliation(s)
- Martin O Furr
- Department of Physiological Sciences, College of Veterinary Medicine, Oklahoma State University, Room 264 McElroy Hall, Stillwater, Ok, USA.
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Edwards LA, Donnelly CG, Reed SM, Valberg S, Chigerwe M, Johnson AL, Finno CJ. Serum and cerebrospinal fluid phosphorylated neurofilament heavy protein concentrations in equine neurodegenerative diseases. Equine Vet J 2021; 54:290-298. [PMID: 33969539 DOI: 10.1111/evj.13452] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/05/2021] [Accepted: 04/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Currently, there is little information regarding the concentrations of phosphorylated neurofilament heavy protein (pNfH) in the serum and cerebrospinal fluid (CSF) of horses with neurodegenerative diseases. Specifically, pNfH concentrations have not yet been evaluated in horses with equine neuroaxonal dystrophy/equine degenerative myeloencephalopathy (eNAD/EDM). OBJECTIVES To determine pNfH concentrations using a commercial enzyme-linked immunosorbent assay (ELISA) in serum and CSF from control horses and horses with eNAD/EDM, cervical vertebral compressive myelopathy (CVCM) and Shivers. STUDY DESIGN Case-control study using biobanked samples from diseased horses and prospective or biobanked samples from control horses. METHODS The pNfH ELISA was performed on samples from horses diagnosed with eNAD/EDM (n = 64), CVCM (n = 26) and Shivers (n = 9) and 51 neurologically normal control horses. RESULTS Median and 95% confidence interval (CI) serum pNfH concentrations in control, CVCM, and eNAD/EDM horses were 0.08 ng/mL (0.07-0.15), 0.07 ng/mL (0.07-0.15) and 0.07 ng/mL (0.07-1.13), respectively. Serum pNfH concentrations were below the limit of detection (<0.07 ng/mL) for all Shivers horses. CSF pNfH concentrations in control, CVCM-, eNAD/EDM- and Shivers-affected horses were 1.26 ng/mL (1.06-1.5), 3.07 ng/mL (1.15-29.9), 1.78 ng/mL (1.5-2.28) and 1.39 ng/mL (0.74-3.89), respectively. CSF pNfH concentrations were significantly higher in CVCM (P = .001) and eNAD/EDM (P = .01) affected horses compared to control horses. Serum pNfH concentrations >1 ng/mL were significantly associated with eNAD/EDM (P = .01) with only 12% sensitivity but 99% specificity. CSF pNfH concentrations >3 ng/mL were significantly associated with CVCM (P = .0002), with 50% sensitivity and 86% specificity. MAIN LIMITATIONS A limited number of control horses tested were <1 year of age. CONCLUSIONS Serum pNfH concentrations are specifically increased (>1 ng/mL) in some horses with eNAD/EDM. Increased CSF pNfH concentrations (>3 ng/mL) can be observed with eNAD/EDM or CVCM.
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Affiliation(s)
- Lisa A Edwards
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Callum G Donnelly
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | | | - Stephanie Valberg
- Department of Large Animal Clinical Sciences, Mary Anne McPhail Equine Performance Center, Michigan State University, East Lansing, MI, USA
| | - Munashe Chigerwe
- Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - Amy L Johnson
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, USA
| | - Carrie J Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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Wong DM. Clinical insights: Recent development in equine neonatology and foal medicine (2017-2019). Equine Vet J 2020; 52:7-10. [PMID: 31821613 DOI: 10.1111/evj.13200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- D M Wong
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic and State University, Blacksburg, Virginia, USA
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Mayaki AM, Abdul Razak IS, Noraniza MA, Mazlina M, Rasedee A. Biofluid Markers of Equine Neurological Disorders Reviewed From Human Perspectives. J Equine Vet Sci 2019; 86:102907. [PMID: 32067661 DOI: 10.1016/j.jevs.2019.102907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/26/2019] [Accepted: 12/26/2019] [Indexed: 02/07/2023]
Abstract
Neurological disorders (NDs) are often fatal to horses. Thus, symptoms of equine NDs commonly indicate euthanasia. Current diagnostic approaches for equine NDs is based on clinical signs, differential diagnoses, analysis of cerebrospinal fluid (CSF), assessment of histopathological lesions, and imaging. However, advances in biofluid biomarkers in the diagnosis of human neurological diseases can potentially be applied to equine NDs. In this review, we described the established human blood and CSF neurobiomarkers that could potentially be used to diagnose equine NDs.
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Affiliation(s)
- Abubakar Musa Mayaki
- Department of Veterinary Pre-Clinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Intan Shameha Abdul Razak
- Department of Veterinary Pre-Clinical Sciences, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| | - Mohd Adzahan Noraniza
- Department of Farm and Exotic Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mazlan Mazlina
- Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Abdullah Rasedee
- Department of Veterinary Laboratory Diagnosis, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Toribio RE. Equine Neonatal Encephalopathy: Facts, Evidence, and Opinions. Vet Clin North Am Equine Pract 2019; 35:363-378. [PMID: 31088699 DOI: 10.1016/j.cveq.2019.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Neonatal encephalopathy (NE) and neonatal maladjustment syndrome (NMS) are terms used for newborn foals that develop noninfectious neurologic signs in the immediate postpartum period. Cerebral ischemia, hypoxia, and inflammation leading to neuronal and glial dysfunction and excitotoxicity are considered key mechanisms behind NE/NMS. Attention has been placed on endocrine and paracrine factors that alter brain cell function. Abnormal steroid concentrations (progestogens, neurosteroids) have been measured in critically ill and NE foals. In addition to supportive treatment, antimicrobials should be considered. Controversies regarding the pathophysiology, diagnosis, and treatment of NE and NMS will remain until controlled mechanistic and therapeutic studies are conducted.
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Affiliation(s)
- Ramiro E Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp Street, Columbus, OH 43210, USA.
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Aleman M, Costa LRR, Crowe C, Kass PH. Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Horses. J Vet Intern Med 2018; 32:1731-1739. [PMID: 30084236 PMCID: PMC6189342 DOI: 10.1111/jvim.15245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/19/2018] [Accepted: 05/22/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Neuroglycopenia refers to a shortage of glucose in the brain resulting in neuronal dysfunction and death if left untreated. Presumed neuroglycopenia has not been described in horses. OBJECTIVE To report neurological signs in horses with presumed neuroglycopenia as the result of severe hypoglycemia. ANIMALS Ninety horses (hours to 28 years of age) diagnosed with hypoglycemia (blood glucose concentration < 75 mg/dL [< 4.2 mmol/L]). METHODS Retrospective study. Electronic medical records were searched. Signalment, history, complaint, clinical signs, laboratory findings including CSF analysis, electroencephalogram, clinical or definitive diagnosis, and outcome were recorded. Kruskal-Wallis analysis of variance and logistic regression were used to investigate association between blood glucose concentration and data extracted. Statistical significance was set at P < 0.05. RESULTS Thirty-eight and 52 horses had mild (50-74 mg/dL [2.8-4.1 mmol/L]), and severe hypoglycemia (< 50 mg/dL [< 2.8 mmol/L]), respectively. Most common causes of hypoglycemia included liver and gastrointestinal (40%) disease, sepsis (33%), neoplasia (7%), and insulin-induced (4%). Most common neurologic deficits included obtundation (100%), seizures (42%), and disorientation (22%). CSF-glucose was severely low (mean 2.5 mg/dL [0.1 mmol/L], median 0 mg/dL). Paroxysmal discharges in support of seizures were identified in the occipital (visual) and parietal (closest to temporal-auditory) cortical regions upon EEG examination (8/8 horses). CONCLUSIONS AND CLINICAL IMPORTANCE Neuroglycopenia is presumed to occur in horses as the result of severe hypoglycemia. Subclinical seizures, and intermittent blindness and deafness of cortical origin can occur. Severe altered state of consciousness and seizures can be observed at a blood glucose cut-off value of < 42 mg/dL (< 2.3 mmol/L).
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Affiliation(s)
- M. Aleman
- From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary MedicineUniversity of CaliforniaDavis
| | - L. R. R. Costa
- From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary MedicineUniversity of CaliforniaDavis
| | - C. Crowe
- From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary MedicineUniversity of CaliforniaDavis
| | - P. H. Kass
- From the Departments of Medicine and Epidemiology (Aleman, Costa), Population Health and Reproduction (Kass), and The William R. Pritchard Veterinary Medical Teaching Hospital (Crowe); School of Veterinary MedicineUniversity of CaliforniaDavis
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Jeawon SS, Katz LM, Galvin NP, Fogarty UM, Duggan VE. Determination of reference intervals for umbilical cord arterial and venous blood gas analysis of healthy Thoroughbred foals. Theriogenology 2018; 118:1-6. [PMID: 29859395 DOI: 10.1016/j.theriogenology.2018.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/18/2018] [Accepted: 05/21/2018] [Indexed: 02/08/2023]
Abstract
Although umbilical cord blood gas analysis is considered the best way to assess in utero oxygenation in human neonates, there is limited evaluation of this method in equine neonatology. Our objectives were to assess the practicality of obtaining umbilical cord blood gas samples in the field and to determine umbilical cord arterial and venous blood gas reference intervals (RI) for healthy, newborn foals. Thoroughbred foals >320 days gestation from healthy mares with uneventful pregnancies at one stud farm were evaluated. All parturitions were observed, with paired umbilical arterial and venous whole-blood samples obtained immediately following parturition for blood gas and lactate concentrations measured in duplicate. Apgar scores were assigned immediately and 10 min after birth, with all foals subsequently examined on days 1-28 to monitor for development of perinatal asphyxia syndrome. Foals were excluded from analysis based on abnormalities of stage 2 labour, Apgar scores and gross and histological placental assessment. Data was analysed using a Student's t-test, Pearson's correlation and the Robust method with P ≤ 0.05 significant. Umbilical cord samples were simple to obtain with minimal disruption to the foaling environment. Of the n = 34 foals assessed, n = 7 were excluded based on premature placental separation deliveries. The mean time for stage 2 labour and blood gas analysis after parturition was 17.3 ± 5.1 min and 5.0 ± 2.3 min, respectively. RI were identified for umbilical arterial and venous pH (7.19-7.42 vs. 7.34-7.44), PO2 (15.5-48.39 mmHg vs. 16.6-52.7 mmHg), PCO2 (49.5-82.29 mmHg vs. 45.4-63.1 mmHg), SO2 (9.19-76.89% vs. 39.9-84.88%), bicarbonate (27.3-38.7 mmol/l vs. 27.7-37.8 mmol/l), base excess (0.36-12.9 mmol/l vs. 1.97-13.1 mmol/l), TCO2 (28.99-40.3 mmHg vs. 29.0-39.5 mmHg) and lactate (1.4-7.3 mmol/l vs. 1.3-4.9 mmol/l). Umbilical arterial samples had lower pH (P < 0.0001), PO2 (P = 0.002) and SO2 (P < 0.0001) and higher PCO2 (P < 0.0001) and lactate (P < 0.0001) than venous samples. The initial Apgar score was positively correlated to umbilical arterial SO2 (r = 0.4, P = 0.05) and negatively with umbilical arterial TCO2 (r = -0.6, P = 0.004). Overall, umbilical cord sampling was simple and minimally disruptive, with RI obtained for blood gas measurements. RI for umbilical blood gas measurements from a larger population of healthy and unhealthy foals is required to evaluate the accuracy of this method for assessing in utero oxygenation.
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Affiliation(s)
- Sunita S Jeawon
- UCD School of Veterinary Medicine, Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Lisa M Katz
- UCD School of Veterinary Medicine, Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
| | | | | | - Vivienne E Duggan
- UCD School of Veterinary Medicine, Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
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15
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16
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Bianco A, Moore G, Taylor S. Neonatal Encephalopathy in Calves Presented to a University Hospital. J Vet Intern Med 2017; 31:1892-1899. [PMID: 28865106 PMCID: PMC5697198 DOI: 10.1111/jvim.14821] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/07/2017] [Accepted: 08/01/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND While studies have examined bovine dystocia in relation to calf survival, little has been published regarding perinatal morbidity and treatment of newborn calves beyond failure of transfer of passive immunity (FTPI). Neonatal encephalopathy (NE) is a clinical syndrome commonly diagnosed in infants and foals but is poorly described in calves. HYPOTHESIS/OBJECTIVES To identify risk factors for development of NE in calves and factors predictive of survival. ANIMALS Neonatal calves presented to a University hospital over a 10-year period. METHODS Retrospective cohort study (2005-2015). Medical records of all neonatal calves presented to the hospital were examined, and cases of NE were identified. Data pertaining to demographics, dam parity, labor, treatment, and outcome were collected and analyzed with univariate and multivariate statistics. RESULTS Of 200 calves in the final analysis, 58 (29%; 95% CI: 22.8-35.8%) were classified as NE and 142 calves as non-NE. In univariate analysis, factors significantly associated with diagnosis of NE included male sex, presence of dystocia, abnormal position in the birth canal, and prolonged labor. In the multivariate model, only orientation of the calf in the birth canal remained significant (OR 2.14; 95% CI: 1.02-4.49; P = 0.044). Overall survival of calves with NE was good (45/58; 77.6%; 95% CI: 64.7-87.5); dam parity and being a twin was significantly associated with nonsurvival. CONCLUSIONS Calves born after dystocia, especially if malpresented, should be closely monitored for nursing behavior within the first 24 hours of life. Prognosis for survival is good, but supportive care might be required for several days.
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Affiliation(s)
- A.W. Bianco
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicinePurdue UniversityWest LafayetteIN
| | - G.E. Moore
- Department of Veterinary AdministrationCollege of Veterinary MedicinePurdue UniversityWest LafayetteIN
| | - S.D. Taylor
- Department of Veterinary Clinical SciencesCollege of Veterinary MedicinePurdue UniversityWest LafayetteIN
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17
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Intan-Shameha A, Divers TJ, Morrow JK, Graves A, Olsen E, Johnson AL, Mohammed HO. Phosphorylated neurofilament H (pNF-H) as a potential diagnostic marker for neurological disorders in horses. Res Vet Sci 2017; 114:401-405. [DOI: 10.1016/j.rvsc.2017.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 07/08/2017] [Accepted: 07/16/2017] [Indexed: 10/19/2022]
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Aleman M, Weich KM, Madigan JE. Survey of Veterinarians Using a Novel Physical Compression Squeeze Procedure in the Management of Neonatal Maladjustment Syndrome in Foals. Animals (Basel) 2017; 7:E69. [PMID: 28872596 PMCID: PMC5615300 DOI: 10.3390/ani7090069] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/27/2017] [Accepted: 09/02/2017] [Indexed: 12/19/2022] Open
Abstract
Horses are a precocious species that must accomplish several milestones that are critical to survival in the immediate post-birth period for their survival. One essential milestone is the successful transition from the intrauterine unconsciousness to an extrauterine state of consciousness or awareness. This transition involves a complex withdrawal of consciousness inhibitors and an increase in neuroactivating factors that support awareness. This process involves neuroactive hormones as well as inputs related to factors such as cold, visual, olfactory, and auditory stimuli. One factor not previously considered in this birth transition is a yet unreported direct neural reflex response to labor-induced physical compression of the fetus in the birth canal (squeezing). Neonatal maladjustment syndrome (NMS) is a disorder of the newborn foal characterized by altered behavior, low affinity for the mare, poor awareness of the environment, failure to bond to the mother, abnormal sucking, and other neurologically-based abnormalities. This syndrome has been associated with altered events during birth, and was believed to be caused exclusively by hypoxia and ischemia. However, recent findings revealed an association of the NMS syndrome with the persistence of high concentrations of in utero neuromodulating hormones (neurosteroids) in the postnatal period. Anecdotal evidence demonstrated that a novel physical compression (squeeze) method that applies 20 min of sustained pressure to the thorax of some neonatal foals with this syndrome might rapidly hasten recovery. This survey provides information about outcomes and time frames to recovery comparing neonatal foals that were given this squeeze treatment to foals treated with routine medical therapy alone. Results revealed that the squeeze procedure, when applied for 20 min, resulted in a faster full recovery of some foals diagnosed with NMS. The adjunctive use of a non-invasive squeeze method may improve animal welfare by hastening recovery and foal-mare interactions that minimize health problems. This would also avoid or reduce costs arising from hospitalization associated with veterinary and nursing care that sometimes leads owners to elect for euthanasia.
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Affiliation(s)
- Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Kalie M Weich
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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19
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Diseases of the Nervous System. Vet Med (Auckl) 2017. [PMCID: PMC7322266 DOI: 10.1016/b978-0-7020-5246-0.00014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Perinatal Diseases. Vet Med (Auckl) 2017. [PMCID: PMC7150149 DOI: 10.1016/b978-0-7020-5246-0.00019-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Wong DM, Jeffery N, Hepworth-Warren KL, Wiechert SA, Miles K. Magnetic resonance imaging of presumptive neonatal encephalopathy in a foal. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- D. M. Wong
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames USA
| | - N. Jeffery
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames USA
| | - K. L. Hepworth-Warren
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames USA
| | - S. A. Wiechert
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames USA
| | - K. Miles
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Iowa State University; Ames USA
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22
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Gold JR, Chaffin K, Burgess BA, Morley PS. Factors Associated With Nonsurvival in Foals Diagnosed With Perinatal Asphyxia Syndrome. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2015.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Affiliation(s)
- J. R. Gold
- Department of Clinical Sciences; Washington State University; Pullman USA
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Aleman M, Pickles KJ, Conley AJ, Stanley S, Haggett E, Toth B, Madigan JE. Abnormal plasma neuroactive progestagen derivatives in ill, neonatal foals presented to the neonatal intensive care unit. Equine Vet J 2013; 45:661-5. [PMID: 23600660 DOI: 10.1111/evj.12065] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 01/18/2013] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING THE STUDY Increased levels of pregnanes have been reported in foals with neonatal maladjustment syndrome (NMS). These steroids may cross the blood-brain barrier and have depressive effects in the central nervous system leading to behavioural abnormalities and altered states of consciousness in affected foals. OBJECTIVES The aim of this study was to determine the pregnane profile of foals with NMS and compare it with that of healthy controls and sick, non-NMS foals. STUDY DESIGN Prospective-clinical study. METHODS Thirty-two foals with a clinical diagnosis of NMS, 12 foals with other neonatal disorders and 10 healthy control foals were selected for the study. Heparinised blood samples were collected from each group of foals and pregnane and androgen concentrations determined using liquid chromatography mass spectrometry at 0, 24 and 48 h of age. RESULTS Healthy foals showed a significant decrease in pregnane concentrations over the first 48 h of life (P<0.01). Foals with NMS and sick, non-NMS foals had significantly increased progesterone, pregnenolone, androstenedione, dehydroepiandrosterone and epitestosterone concentrations compared with healthy foals (P<0.05). Progesterone and pregnenolone concentrations of sick, non-NMS foals decreased significantly over 48 h (P<0.05), whereas concentrations in NMS foals remained increased. CONCLUSIONS AND POTENTIAL RELEVANCE Pregnane concentrations of ill, neonatal foals remain increased following birth, reflecting a delayed, or interrupted, transition from intra- to extra-uterine life. Serial progesterone and pregnenolone measurement may be useful in aiding diagnosis of NMS.
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Affiliation(s)
- M Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine University of California, USA
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26
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STRATFORD CH, PEMBERTON A, CAMERON L, McGORUM BC. Plasma neurofilament pNF-H concentration is not increased in acute equine grass sickness. Equine Vet J 2012; 45:254-5. [DOI: 10.1111/j.2042-3306.2012.00603.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Madigan JE, Haggettt EF, Pickles KJ, Conley A, Stanley S, Moeller B, Toth B, Aleman M. Allopregnanolone infusion induced neurobehavioural alterations in a neonatal foal: is this a clue to the pathogenesis of neonatal maladjustment syndrome? Equine Vet J 2012:109-12. [PMID: 22594038 DOI: 10.1111/j.2042-3306.2011.00504.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING THE STUDY Increased plasma progestagen concentrations have been reported in foals with neonatal maladjustment syndrome (NMS). These steroids may cross the blood-brain barrier and have dampening effects in the central nervous system. OBJECTIVES To evaluate if the infusion of a progesterone derivative (allopregnanolone) in a healthy neonatal foal would induce clinical signs compatible with NMS. METHODS A healthy neonatal foal from a healthy mare with a normal gestation (length, no complications), birth and placenta was infused with allopregnanolone to observe its neurobehavioural effects. Heparinised blood samples were collected pre- and post infusion to determine various progestagen concentrations using liquid chromatography mass spectrometry. A second healthy neonatal foal was infused with ethanol and saline for comparison of clinical observations. RESULTS Infusion of allopregnanolone resulted in obtundation, lack of affinity for the mare and decreased response to external stimuli. These effects were short-lasting and associated with measurable concentrations of progestagens. CONCLUSIONS AND POTENTIAL RELEVANCE Infusion of a steroid metabolite to a healthy neonatal foal resulted in neurobehavioural alterations compatible with those observed in foals with NMS. These findings suggest that increased progestagen concentrations may be responsible for some of the behavioural changes observed in foals with NMS.
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Affiliation(s)
- J E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, USA
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Kaura V, Bonner S. Subarachnoid haemorrhage: Early clinical indicators and biomarkers. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2012. [DOI: 10.1016/j.tacc.2011.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Dickey EJ, Long SN, Hunt RW. Hypoxic ischemic encephalopathy--what can we learn from humans? J Vet Intern Med 2011; 25:1231-40. [PMID: 22092610 DOI: 10.1111/j.1939-1676.2011.00818.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 06/06/2011] [Accepted: 08/30/2011] [Indexed: 01/17/2023] Open
Abstract
Hypoxic ischemic encephalopathy (HIE) is a condition that occurs in both human newborns and foals. The condition is the subject of extensive current research in human infants, but there have been no direct studies of HIE in foals, and hence, knowledge of the condition has been extrapolated from studies in humans and other animal models. The purpose of this review article is to highlight the most up-to-date and relevant research in the human field, and discuss how this potentially might have an impact in the management of foals with HIE.
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Affiliation(s)
- E J Dickey
- Neonatal Research, Murdoch Children's Research Institute, Melbourne, Australia.
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Neurofilament proteins as body fluid biomarkers of neurodegeneration in multiple sclerosis. Mult Scler Int 2011; 2011:315406. [PMID: 22096635 PMCID: PMC3195785 DOI: 10.1155/2011/315406] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Accepted: 12/23/2010] [Indexed: 01/17/2023] Open
Abstract
Biomarkers of axonal degeneration have the potential to improve our capacity to predict and monitor neurological outcome in multiple sclerosis (MS) patients. Neurofilament proteins, one of the major proteins expressed within neurons and axons, have been detected in cerebrospinal fluid and blood samples from MS patients and are now being actively investigated for their utility as prognostic indicators of disease progression in MS. In this paper, we summarize the current literature on neurofilament structure, assembly, and degeneration and discuss their potential utility as biomarkers for monitoring neurological decline in MS. We also discuss the need to further develop sensitive methods for assaying neurofilaments in blood to improve clinical applicability.
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