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Salih BA, Abdullah BH. Comparative Immunohistochemical Analysis of Craniopharyngioma and Ameloblastoma: Insights into Odontogenic Differentiation. Diagnostics (Basel) 2024; 14:2315. [PMID: 39451638 PMCID: PMC11506693 DOI: 10.3390/diagnostics14202315] [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: 08/30/2024] [Revised: 10/10/2024] [Accepted: 10/14/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Histopathological similarities between craniopharyngioma (CP) and ameloblastoma (AB) have long been recognized, particularly the shared features of palisading columnar epithelium and stellate reticulum-like areas. This study aimed to investigate potential odontogenic differentiation in CP akin to AB using immunohistochemical odontogenic markers. METHODS We analyzed AMELX, ODAM, and CK19 expression in 44 cases (20 CP and 24 AB). RESULTS While AMELX and ODAM showed diffuse strong positive expression in both tumors with no significant statistical differences, CK19 expression was notably higher in CP. CONCLUSION The markers AMELX and ODAM associated with odontogenic differentiation exhibited similar profiles in both tumors due to shared similar embryological origins. Notably, CK19, a biomarker of odontogenic epithelium, showed even higher expression, suggesting distinct pathways. These findings offer insights into tumor biology and may aid in diagnostic and therapeutic approaches.
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Affiliation(s)
- Ban A. Salih
- College of Dentistry, University of Baghdad, Baghdad 10071, Iraq;
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Iwaide S, Murakami T, Sedghi Masoud N, Kobayashi N, Fortin JS, Miyahara H, Higuchi K, Chambers JK. Classification of amyloidosis and protein misfolding disorders in animals 2024: A review on pathology and diagnosis. Vet Pathol 2024:3009858241283750. [PMID: 39389927 DOI: 10.1177/03009858241283750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Amyloidosis is a group of diseases in which proteins become amyloid, an insoluble fibrillar aggregate, resulting in organ dysfunction. Amyloid deposition has been reported in various animal species. To diagnose and understand the pathogenesis of amyloidosis, it is important to identify the amyloid precursor protein involved in each disease. Although 42 amyloid precursor proteins have been reported in humans, little is known about amyloidosis in animals, except for a few well-described amyloid proteins, including amyloid A (AA), amyloid light chain (AL), amyloid β (Aβ), and islet amyloid polypeptide-derived amyloid. Recently, several types of novel amyloidosis have been identified in animals using immunohistochemistry and mass spectrometry-based proteomic analysis. Certain species are predisposed to specific types of amyloidosis, suggesting a genetic background for its pathogenesis. Age-related amyloidosis has also emerged due to the increased longevity of captive animals. In addition, experimental studies have shown that some amyloids may be transmissible. Accurate diagnosis and understanding of animal amyloidosis are necessary for appropriate therapeutic intervention and comparative pathological studies. This review provides an updated classification of animal amyloidosis, including associated protein misfolding disorders of the central nervous system, and the current understanding of their pathogenesis. Pathologic features are presented together with state-of-the-art diagnostic methods that can be applied for routine diagnosis and identification of novel amyloid proteins in animals.
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Affiliation(s)
- Susumu Iwaide
- Tokyo University of Agriculture and Technology, Fuchu-shi, Japan
| | - Tomoaki Murakami
- Tokyo University of Agriculture and Technology, Fuchu-shi, Japan
| | | | | | | | | | - Keiichi Higuchi
- Shinshu University, Matsumoto, Japan
- Meio University, Nago, Japan
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Palizzotto C, Ferri F, Callegari C, Rossi F, Manfredi M, Carcangiu L, Gerardi G, Ferro S, Cavicchioli L, Müller E, Weiss M, Vogt A, Lavatelli F, Ricagno S, Hurley K, Zini E. Renal amyloid-A amyloidosis in cats: Characterization of proteinuria and biomarker discovery, and associations with kidney histology. J Vet Intern Med 2024; 38:205-215. [PMID: 37991136 PMCID: PMC10800178 DOI: 10.1111/jvim.16920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Amyloid A (AA) amyloidosis is a protein misfolding disease arising from serum amyloid A (SAA). Systemic AA amyloidosis recently was shown to have a high prevalence in shelter cats in Italy and was associated with azotemia and proteinuria. OBJECTIVES Investigate urine protein profiles and diagnostic biomarkers in cats with renal AA amyloidosis. ANIMALS Twenty-nine shelter cats. METHODS Case-control study. Cats with renal proteinuria that died or were euthanized between 2018 and 2021 with available necropsy kidney, liver and spleen samples, and with surplus urine collected within 30 days before death, were included. Histology was used to characterize renal damage and amyloid amount and distribution; immunohistochemistry was used to confirm AA amyloidosis. Urine protein-to-creatinine (UPC) and urine amyloid A-to-creatinine (UAAC) ratios were calculated, and sodium dodecyl sulfate-agarose gel electrophoresis (SDS-AGE) and liquid chromatography-mass spectrometry (LC-MS) of proteins were performed. RESULTS Twenty-nine cats were included. Nineteen had AA amyloidosis with renal involvement. Cats with AA amyloidosis had a higher UPC (median, 3.9; range, 0.6-12.7 vs 1.5; 0.6-3.1; P = .03) and UAAC ratios (median, 7.18 × 10-3 ; range, 23 × 10-3 -21.29 × 10-3 vs 1.26 × 10-3 ; 0.21 × 10-3 -6.33 × 10-3 ; P = .04) than unaffected cats. The SDS-AGE identified mixed-type proteinuria in 89.4% of cats with AA amyloidosis and in 55.6% without AA amyloidosis (P = .57). The LC-MS identified 63 potential biomarkers associated with AA amyloidosis (P < .05). Among these, urine apolipoprotein C-III was higher in cats with AA amyloidosis (median, 1.38 × 107 ; range, 1.85 × 105 -5.29 × 107 vs 1.76 × 106 ; 0.0 × 100 -1.38 × 107 ; P = .01). In the kidney, AA-amyloidosis was associated with glomerulosclerosis (P = .02) and interstitial fibrosis (P = .05). CONCLUSIONS AND CLINICAL IMPORTANCE Renal AA amyloidosis is associated with kidney lesions, increased proteinuria and increased urine excretion of SAA in shelter cats. Additional studies are needed to characterize the role of lipid transport proteins in the urine of affected cats.
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Affiliation(s)
- Carlo Palizzotto
- AniCura Istituto Veterinario NovaraGranozzo con MonticelloNOItaly
| | - Felippo Ferri
- AniCura Istituto Veterinario NovaraGranozzo con MonticelloNOItaly
- Department of Animal Medicine, Production and HealthUniversity of PadovaLegnaroPDItaly
- Studio Veterinario Associato Vet2Vet di Ferri e PorporatoOrbassanoTOItaly
| | | | - Francesco Rossi
- AniCura Istituto Veterinario NovaraGranozzo con MonticelloNOItaly
| | - Marcello Manfredi
- Department of Translational MedicineUniversity of Piemonte OrientaleNovaraItaly
| | - Laura Carcangiu
- Department of Translational MedicineUniversity of Piemonte OrientaleNovaraItaly
| | - Gabriele Gerardi
- Department of Animal Medicine, Production and HealthUniversity of PadovaLegnaroPDItaly
| | - Silvia Ferro
- Department of Comparative Biomedicine and Food ScienceUniversity of PadovaLegnaroPDItaly
| | - Laura Cavicchioli
- Department of Comparative Biomedicine and Food ScienceUniversity of PadovaLegnaroPDItaly
| | - Elizabeth Müller
- Laboklin, Laboratory for Clinical DiagnosticsBad KissingenGermany
| | - Marco Weiss
- Laboklin, Laboratory for Clinical DiagnosticsBad KissingenGermany
| | - Anne‐Catherine Vogt
- Department of Rheumatology and ImmunologyUniversity Hospital BernBernSwitzerland
- Department of BioMedical ResearchUniversity of BernBernSwitzerland
- Graduate School for Cellular and Biomedical Sciences (GCB)University of BernBernSwitzerland
| | | | - Stefano Ricagno
- Institute of Molecular and Translational CardiologyIRCCS Policlinico San DonatoMilanItaly
- Department of BiosciencesUniversità degli Studi di MilanoMilanItaly
| | | | - Eric Zini
- AniCura Istituto Veterinario NovaraGranozzo con MonticelloNOItaly
- Department of Animal Medicine, Production and HealthUniversity of PadovaLegnaroPDItaly
- Clinic for Small Animal Internal Medicine, Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Identification of Ameloblastin as an Amyloid Precursor Protein of Amyloid-Producing Ameloblastoma in Dogs and Cats. Vet Sci 2023; 10:vetsci10020166. [PMID: 36851470 PMCID: PMC9963920 DOI: 10.3390/vetsci10020166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Amyloid-producing ameloblastoma (APAB) is characterized by abundant amyloid deposits in ameloblastoma, but the amyloid precursor protein is unknown. To explore this, we conducted histopathologic and proteomic analyses on formalin-fixed and paraffin-embedded samples from five cases of APAB (three dogs and two cats). Histologically, the samples exhibited a proliferation of the odontogenic epithelium, with moderate to severe interstitial amyloid deposits. By using Congo red and polarized light, the amyloid deposits were found to show characteristic birefringence. Amyloid deposits were dissected from tissue sections and analyzed by LC/MS/MS, and high levels of ameloblastin were detected in all tissues. Mass spectrometry also revealed that the N-terminal region of ameloblastin is predominantly present in amyloid deposits. Immunohistochemistry was performed using two anti-ameloblastin (N terminal, middle region) antibodies and showed that amyloid deposits were positive for ameloblastin N terminal but negative for ameloblastin middle region. These results suggest that ameloblastin is the amyloid precursor protein of APABs in dogs and cats, and the N-terminal region may be involved in the amyloidogenesis of ameloblastin.
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Blackford Winders C, Bell CM, Goldschmidt S. Case Report: Amyloid-Producing Odontogenic Tumor With Pulmonary Metastasis in a Spinone Italiano-Proof of Malignant Potential. Front Vet Sci 2020; 7:576376. [PMID: 33134357 PMCID: PMC7552887 DOI: 10.3389/fvets.2020.576376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/21/2020] [Indexed: 11/13/2022] Open
Abstract
A 1-year-old male Spinone Italiano dog was treated for an amyloid-producing odontogenic tumor on the right maxilla with a cytoreductive surgery followed by a definitive radiation protocol. Six years later, the dog presented for a new mass on the rostral mandible as well as a lung nodule without recurrence of the original maxillary tumor. Both the mandibular mass and the lung nodule were histologically confirmed to be amyloid-producing odontogenic tumor based on the appearance of sheets and cords of the odontogenic epithelium disrupted by amorphous extracellular amyloid. This case illustrates the metastatic potential for amyloid-producing odontogenic tumor in dogs and asynchronous occurrence of multiple APOTs in the oral cavity.
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Affiliation(s)
| | - Cynthia M Bell
- Specialty Oral Pathology for Animals, Geneseo, IL, United States
| | - Stephanie Goldschmidt
- College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States
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Zayas-Santiago A, Díaz-García A, Nuñez-Rodríguez R, Inyushin M. Accumulation of amyloid beta in human glioblastomas. Clin Exp Immunol 2020; 202:325-334. [PMID: 32654112 PMCID: PMC7670151 DOI: 10.1111/cei.13493] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/12/2022] Open
Abstract
Many cancer types are intrinsically associated with specific types of amyloidosis, in which amyloid is accumulated locally inside tumors or systemically. Usually, this condition relates to the hyperproduction of specific amylogenic proteins. Recently, we found that the accumulation of amyloid beta (Aβ) peptide immunofluorescence is linked to glioma cells in mouse tumors. Here we report that amyloid-specific histochemical dyes reveal amyloid accumulation in all human glioma samples. Application of two different antibodies against Aβ peptide (a polyclonal antibody against human Aβ1-42 and a monoclonal pan-specific mAb-2 antibody against Aβ) showed that the amyloid in glioma samples contains Aβ. Amyloid was linked to glioma cells expressing glial-specific fibrillary acidic protein (GFAP) and to glioma blood vessels. Astrocytes close to the glioma site and to affected vessels also accumulated Aβ. We discuss whether amyloid is produced by glioma cells or is the result of systemic production of Aβ in response to glioma development due to an innate immunity reaction. We conclude that amyloid build-up in glioma tumors is a part of the tumor environment, and may be used as a target for developing a novel class of anti-tumor drugs and as an antigen for glioma visualization.
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Affiliation(s)
- A Zayas-Santiago
- Physiology Department, Medical School, Universidad Central del Caribe, Bayamon, Puerto Rico
| | - A Díaz-García
- Physiology Department, Medical School, Universidad Central del Caribe, Bayamon, Puerto Rico
| | - R Nuñez-Rodríguez
- Biochemistry Department, Medical School, Universidad Central del Caribe, Bayamon, Puerto Rico
| | - M Inyushin
- Physiology Department, Medical School, Universidad Central del Caribe, Bayamon, Puerto Rico
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Miyazaki S, Kadota A, Mitsui I, Murakami T. Amyloid Signature Proteins in Feline Amyloidosis. J Comp Pathol 2020; 177:10-17. [PMID: 32505236 DOI: 10.1016/j.jcpa.2020.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/12/2020] [Accepted: 03/19/2020] [Indexed: 12/12/2022]
Abstract
In human amyloidoses, amyloid signature proteins (ASPs), such as serum amyloid P component (SAP) and apolipoprotein E (ApoE), are deposited in tissues together with amyloid fibrils and are implicated in the pathogenesis of amyloidosis. Few reports describe ASPs in animals. In this study, we examined feline amyloidosis and performed immunohistochemical and proteomic analyses of SAP, ApoE, apolipoprotein A-I (ApoAI) and apolipoprotein A-IV (ApoAIV). Ten cases of systemic amyloidosis, three cases of amyloid-producing odontogenic tumour and three cases of islet amyloidosis were used for immunohistochemistry (IHC) and/or proteomic analyses. IHC showed that ApoE was present in amyloid deposits in all samples. ApoAI and ApoAIV differed in the degree of co-deposition with amyloid depending on the type of amyloid and the affected organ. SAP was negative in all amyloid deposits. Proteomic analysis showed that ApoE was present in all samples, but ApoAI and ApoAIV were detected only in some samples and SAP was not detected in any samples. The observation that ApoE was detected in all types of amyloid suggests the involvement of ApoE in the development of feline amyloidosis. ASPs in feline amyloidosis are significantly different from those in human amyloidosis, suggesting that the involvement of ASPs in the pathological condition differs between animal species.
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Affiliation(s)
- S Miyazaki
- Laboratory of Veterinary Toxicology, Cooperative Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - A Kadota
- Laboratory of Veterinary Toxicology, Cooperative Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - I Mitsui
- Laboratory of Veterinary Pathology, Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Ehime, Japan
| | - T Murakami
- Laboratory of Veterinary Toxicology, Cooperative Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo, Japan.
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Kucheryavykh LY, Ortiz-Rivera J, Kucheryavykh YV, Zayas-Santiago A, Diaz-Garcia A, Inyushin MY. Accumulation of Innate Amyloid Beta Peptide in Glioblastoma Tumors. Int J Mol Sci 2019; 20:ijms20102482. [PMID: 31137462 PMCID: PMC6567111 DOI: 10.3390/ijms20102482] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 04/23/2019] [Accepted: 05/15/2019] [Indexed: 12/12/2022] Open
Abstract
Immunostaining with specific antibodies has shown that innate amyloid beta (Aβ) is accumulated naturally in glioma tumors and nearby blood vessels in a mouse model of glioma. In immunofluorescence images, Aβ peptide coincides with glioma cells, and enzyme-linked immunosorbent assay (ELISA) have shown that Aβ peptide is enriched in the membrane protein fraction of tumor cells. ELISAs have also confirmed that the Aβ(1–40) peptide is enriched in glioma tumor areas relative to healthy brain areas. Thioflavin staining revealed that at least some amyloid is present in glioma tumors in aggregated forms. We may suggest that the presence of aggregated amyloid in glioma tumors together with the presence of Aβ immunofluorescence coinciding with glioma cells and the nearby vasculature imply that the source of Aβ peptides in glioma can be systemic Aβ from blood vessels, but this question remains unresolved and needs additional studies.
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Affiliation(s)
- Lilia Y Kucheryavykh
- Department of Biochemistry, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
| | - Jescelica Ortiz-Rivera
- Department of Biochemistry, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
| | - Yuriy V Kucheryavykh
- Department of Biochemistry, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
| | - Astrid Zayas-Santiago
- Department of Physiology, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
| | - Amanda Diaz-Garcia
- Department of Physiology, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
| | - Mikhail Y Inyushin
- Department of Physiology, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamon, PR 00960-6032, USA.
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Immunohistochemical Profile of Ameloblastic Carcinoma Arising from an Amyloid-Producing Odontogenic Tumour in a Miniature Dachshund. J Comp Pathol 2018; 166:54-58. [PMID: 30691607 DOI: 10.1016/j.jcpa.2018.10.182] [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: 10/02/2018] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 11/20/2022]
Abstract
A 13-year-old female miniature dachshund was presented with a centrally-located sublingual mass in the rostral mandibular region. The focally ulcerated growth completely covered the left (305) and right (405) premolar teeth and partially covered the right canine teeth (404). A punch biopsy sample revealed neoplastic proliferation of odontogenic epithelium arranged in irregular cords with frequent comedo-like necrosis. Following the initial diagnosis of ameloblastic carcinoma, a bilateral rostral hemimandibulectomy was performed. Although the detailed examination of the resected mass was consistent with the initial diagnosis, it also contained birefringent congophilic, amelogenin-labelled amyloid deposits similar to an amyloid-producing odontogenic tumour (APOT) in 30-40% of the mass, in continuity with the ameloblastic carcinoma. All neoplastic cells had diffuse moderate expression of cytokeratin (CK) AE1/AE3 and CK5, diffuse mild expression of CK14 and multifocal moderate expression of CK19. Because the APOT-like growth in the mass was histologically benign, the tumour was diagnosed as an ameloblastic carcinoma arising from an APOT.
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Kok M, Chambers J, Ushio N, Miwa Y, Nakayama H, Uchida K. Amyloid-producing Odontoameloblastoma in a Black-tailed Prairie Dog (Cynomys ludovicianus). J Comp Pathol 2018; 159:26-30. [DOI: 10.1016/j.jcpa.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 11/17/2022]
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Hirayama K, Endoh C, Kagawa Y, Ohmachi T, Yamagami T, Nomura K, Matsuda K, Okamoto M, Taniyama H. Amyloid-Producing Odontogenic Tumors of the Facial Skin in Three Cats. Vet Pathol 2016; 54:218-221. [PMID: 27511309 DOI: 10.1177/0300985816660746] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Amyloid-producing odontogenic tumors (APOTs) of the facial skin were diagnosed in 3 domestic cats. The neoplasms had the histopathological characteristics of the odontogenic tumor. The neoplastic cells were present in irregular islands, strands, and sheets. The peripheral neoplastic cells of the islands and strands were arranged in a palisading fashion, while the central cells were polyhedral to stellate and randomly arranged. Multiple spherules of homogeneous eosinophilic material were closely apposed to the neoplastic epithelial cells. The spherules stained with Congo red and produced an apple green birefringence under polarization microscopy, indicative of amyloid. Immunohistochemically, amyloid materials of the neoplasms reacted with polyclonal antibodies for ameloblastin, amelogenin, and sheathlin antibodies. Neoplastic epithelial cells also reacted with antiameloblastin, amelogenin, and sheathlin antibodies, with varied intensity. The histopathological and immunohistochemical characteristics of dermal neoplasms of the 3 cats were analogous to those of APOTs reported in the dog and the cat.
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Affiliation(s)
- K Hirayama
- 1 Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
| | - C Endoh
- 1 Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
| | | | - T Ohmachi
- 3 Patho Labo Co, Ltd, Shizuoka, Japan
| | | | - K Nomura
- 4 Marupi Lifetech Co, Ltd, Osaka, Japan
| | - K Matsuda
- 1 Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
| | - M Okamoto
- 1 Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
| | - H Taniyama
- 1 Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
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