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Höglund N, Rossi H, Javela HM, Oikari S, Nieminen P, Mustonen AM, Airas N, Kärjä V, Mykkänen A. The amount of hyaluronic acid and airway remodelling increase with the severity of inflammation in neutrophilic equine asthma. BMC Vet Res 2024; 20:273. [PMID: 38918797 PMCID: PMC11197223 DOI: 10.1186/s12917-024-04136-2] [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: 02/08/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Equine asthma (EA) is a chronic lower airway inflammation that leads to structural and functional changes. Hyaluronic acid (HA) has crucial functions in the extracellular matrix homeostasis and inflammatory mediator activity. HA concentration in the lungs increases in several human airway diseases. However, its associations with naturally occurring EA and airway remodelling have not been previously studied. Our aim was to investigate the association of equine neutrophilic airway inflammation (NAI) severity, airway remodelling, and HA concentration in horses with naturally occurring EA. We hypothesised that HA concentration and airway remodelling would increase with the severity of NAI. HA concentrations of bronchoalveolar lavage fluid supernatant (SUP) and plasma of 27 neutrophilic EA horses, and 28 control horses were measured. Additionally, remodelling and HA staining intensity were assessed from endobronchial biopsies from 10 moderate NAI horses, 5 severe NAI horses, and 15 control horses. RESULTS The HA concentration in SUP was higher in EA horses compared to controls (p = 0.007). Plasma HA concentrations were not different between the groups. In the endobronchial biopsies, moderate NAI horses showed epithelial hyperplasia and inflammatory cell infiltrate, while severe NAI horses also showed fibrosis and desquamation of the epithelium. The degree of remodelling was higher in severe NAI compared to moderate NAI (p = 0.048) and controls (p = 0.016). Intense HA staining was observed in bronchial cell membranes, basement membranes, and connective tissue without significant differences between the groups. CONCLUSION The release of HA to the airway lumen increases in naturally occurring neutrophilic EA without clear changes in its tissue distribution, and significant airway remodelling only develops in severe NAI.
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Affiliation(s)
- Nina Höglund
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland.
| | - Heini Rossi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Hanna-Maaria Javela
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Sanna Oikari
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
| | - Petteri Nieminen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
| | - Anne-Mari Mustonen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
- Department of Environmental and Biological Sciences, Faculty of Science, Forestry and Technology, University of Eastern Finland, Joensuu, FI-80101, Finland
| | - Niina Airas
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Vesa Kärjä
- Department of Clinical Pathology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, FI-70210, Finland
| | - Anna Mykkänen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
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Leduc L, Leclère M, Lavoie JP. Towards personalized medicine for the treatment of equine asthma. Vet J 2024; 305:106125. [PMID: 38704018 DOI: 10.1016/j.tvjl.2024.106125] [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: 02/20/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Although horses with asthma share similar clinical signs, the heterogeneity of the disease in terms of severity, triggering factors, inflammatory profile, and pathological features has hindered our ability to define biologically distinct subgroups. The recognition of phenotypes and endotypes could enable the development of precision medicine, including personalized, targeted therapy, to benefit affected horses. While in its infancy in horses, this review outlines the phenotypes of equine asthma and discusses how knowledge gained from targeted therapy in human medicine can be applied to evaluate the potential opportunities for personalized medicine in equine asthma and to suggest avenues for research to advance this emerging field.
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Affiliation(s)
- Laurence Leduc
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Mathilde Leclère
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada.
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Simões J, Tilley P. Decision Making in Severe Equine Asthma-Diagnosis and Monitoring. Animals (Basel) 2023; 13:3872. [PMID: 38136909 PMCID: PMC10740644 DOI: 10.3390/ani13243872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Decision making consists of gathering quality data in order to correctly assess a situation and determine the best course of action. This process is a fundamental part of medicine and is what enables practitioners to accurately diagnose diseases and select appropriate treatment protocols. Despite severe equine asthma (SEA) being a highly prevalent lower respiratory disease amongst equids, clinicians still struggle with the optimization of routine diagnostic procedures. The use of several ancillary diagnostic tests has been reported for disease identification and monitoring, but many are only suitable for research purposes or lack practicality for everyday use. The aim of this paper is to assist the equine veterinarian in the process of decision making associated with managing SEA-affected patients. This review will focus on disease diagnosis and monitoring, while also presenting a flow-chart which includes the basic data that the clinician must obtain in order to accurately identify severely asthmatic horses in their everyday routine practice. It is important to note that European and American board-certified specialists on equine internal medicine can provide assistance in the diagnosis and treatment plan of SEA-affected horses.
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Affiliation(s)
- Joana Simões
- Equine Health and Welfare Academic Division, Faculty of Veterinary Medicine, Lusófona University, Campo Grande 376, 1749-024 Lisbon, Portugal
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4Animals), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - Paula Tilley
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4Animals), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
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Chu F, Liang L, Chen F. Effect of budesonide combined with montelukast sodium on pulmonary function parameters and immunoglobulin levels in children with bronchial asthma. Allergol Immunopathol (Madr) 2023; 51:151-157. [PMID: 37422792 DOI: 10.15586/aei.v51i4.897] [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: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND AND AIM Bronchial asthma is a prevalent type of respiratory disease that affects a large proportion of pediatric patients. The purpose of this study is to further investigate the clinical effects of budesonide combined with montelukast sodium in treating bronchial asthma. METHODS Eighty six children with bronchial asthma were equally divided into study and control groups via randomized double-blind controlled trial. The control group was treated with aerosol inhalation of budesonide combined with placebo, while the study group was treated with budesonide combined with montelukast sodium. Pulmonary function parameters, immunoglobulin, and recovery of related symptoms, along with the adverse reaction rate, were observed and compared between both groups. RESULTS Before treatment, there was no marked difference in pulmonary function parameters and immunoglobulin indexes between both groups (P > 0.05). All pulmonary function indicators and immunoglobulin indexes in both groups improved following therapy, with the study group outperforming the control group (P < 0.05). The recovery time of related symptoms in the study group was shorter than that in the control group (P < 0.05). The incidence of adverse reactions in both groups was compared, with notable differences (P < 0.05). CONCLUSION Budesonide combined with montelukast sodium in the treatment of bronchial asthma has the value of clinical application and promotion.
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Affiliation(s)
- Fangfang Chu
- Department of Pediatric Respiratory, Anhui Provincial Children's Hospital, Hefei City, Anhui Province, 230051, China
| | - Lei Liang
- Department of Pediatric Respiratory, Anhui Provincial Children's Hospital, Hefei City, Anhui Province, 230051, China;
| | - Fuzhe Chen
- Department of Pediatric Respiratory, Anhui Provincial Children's Hospital, Hefei City, Anhui Province, 230051, China
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The Immune Mechanisms of Severe Equine Asthma-Current Understanding and What Is Missing. Animals (Basel) 2022; 12:ani12060744. [PMID: 35327141 PMCID: PMC8944511 DOI: 10.3390/ani12060744] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 01/27/2023] Open
Abstract
Severe equine asthma is a chronic respiratory disease of adult horses, occurring when genetically susceptible individuals are exposed to environmental aeroallergens. This results in airway inflammation, mucus accumulation and bronchial constriction. Although several studies aimed at evaluating the genetic and immune pathways associated with the disease, the results reported are inconsistent. Furthermore, the complexity and heterogeneity of this disease bears great similarity to what is described for human asthma. Currently available studies identified two chromosome regions (ECA13 and ECA15) and several genes associated with the disease. The inflammatory response appears to be mediated by T helper cells (Th1, Th2, Th17) and neutrophilic inflammation significantly contributes to the persistence of airway inflammatory status. This review evaluates the reported findings pertaining to the genetical and immunological background of severe equine asthma and reflects on their implications in the pathophysiology of the disease whilst discussing further areas of research interest aiming at advancing treatment and prognosis of affected individuals.
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