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Hernandez SI, Assenmacher CA, Church ME, Alvarez JI. Astroglial Dysfunction, Demyelination and Nodular inflammation in Necrotizing Meningoencephalitis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.11.11.623107. [PMID: 39605694 PMCID: PMC11601332 DOI: 10.1101/2024.11.11.623107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2024]
Abstract
Necrotizing Meningoencephalitis (NME), a form of Meningoencephalitis of Unknown Origin (MUO), is a progressive neuroinflammatory disease that primarily affects young, small-breed dogs. Due to limited understanding of its pathophysiology, early detection and the development of targeted therapies remain challenging. Definitive ante-mortem diagnosis is often unfeasible, and dogs with NME are frequently grouped under the broader MUO category. Our long-term objective is to identify distinct disease mechanisms within each MUO subtype to improve diagnostic accuracy, therapeutic approaches, and prognostic outcomes. To establish unique inflammatory patterns as they relate to neuropathologic changes in NME, we studied we studied the degree of immune cell infiltration, astrogliosis, demyelination, and microglial activation, comparing these factors with granulomatous meningoencephalomyelitis (GME), a closely related MUO subtype. We found that in the leptomeninges, NME is characterized by mild immune cell infiltration, in contrast to the prominent, B cell-rich aggregates seen in GME. In the neuroparenchyma, both diseases exhibit a comparable degree of lymphocyte infiltration; however, demyelination is more pronounced in NME, particularly within the subcortical white matter. Notably, areas of the brain affected by NME display a reduction in astrogliosis, which is associated with a marked decrease in the expression of the water channel protein aquaporin-4 (AQP4), a reduction not observed in GME. Additionally, we found that AQP4 expression levels correlate with the extent of microglial and macrophage activation. These findings suggest that astrocyte dysfunction in regions of microglial inflammation is a driver of NME and with adaptive immune responses likely playing a supportive role.
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van Renen J, Kehl A, Buhmann G, Matiasek LA, Zablotski Y, Fischer A. Allele frequency of a genetic risk variant for necrotizing meningoencephalitis in pug dogs from Europe and association with the clinical phenotype. Front Vet Sci 2024; 11:1407288. [PMID: 38840637 PMCID: PMC11150678 DOI: 10.3389/fvets.2024.1407288] [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: 03/26/2024] [Accepted: 04/30/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Necrotizing meningoencephalitis (NME) in pugs is a potentially fatal disease, which needs lifelong treatment with immunosuppressive or immunomodulatory drugs and shares parallels with acute fulminating multiple sclerosis. Genetic variants of the DLA class II gene are associated with an increased risk for NME. Genetic testing is recommended prior to breeding. The aim of this study was to describe the current allele frequency of a previously identified NME risk variant in the European pug population. A secondary aim was to investigate the association of the NME risk variant with the clinical phenotype in pugs. Methods Results of genetic testing for the CFA12:2605517delC variant in European pugs between 2012 and 2020 were retrieved (n = 5,974). A validated questionnaire was mailed to all submitters of samples for further information on neurological signs, diagnostic tests, and disease course. Results The allele frequency of the CFA12 NME risk variant was 25.7% in the European pug population dogs; 7.4% of the dogs were homozygous and 36.7% were heterozygous for the NME risk variant on CFA12. Completed questionnaires were available in 203 dogs including 25 dogs with epileptic seizures or other neurological signs. The clinical phenotype was consistent with NME in 3.9% with a median age of onset of 1.0 years, and indicative of idiopathic epilepsy in 2.9% with a median onset of 2.5 years. Eleven dogs remained unclassified. Pugs with the NME phenotype were significantly more frequently homozygous for the NME risk variant on CFA12 compared to pugs ≥6 years without neurological signs or seizures (p = 0.008). Discussion The CFA12:2605517delC genetic risk variant is widely distributed in the European pug population and frequently homozygous in pugs with a NME phenotype. The data support the clinical relevance of the CFA12:2605517delC genetic risk variant.
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Affiliation(s)
- Jana van Renen
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Alexandra Kehl
- Laboklin, Bad Kissingen, Germany
- Comparative Experimental Pathology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Gesine Buhmann
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lara A. Matiasek
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Yury Zablotski
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Andrea Fischer
- Small Animal Clinic, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
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Guo Y, Endmayr V, Zekeridou A, McKeon A, Leypoldt F, Hess K, Kalinowska-Lyszczarz A, Klang A, Pakozdy A, Höftberger E, Hametner S, Haider C, De Simoni D, Peters S, Gelpi E, Röcken C, Oberndorfer S, Lassmann H, Lucchinetti CF, Höftberger R. New insights into neuropathology and pathogenesis of autoimmune glial fibrillary acidic protein meningoencephalomyelitis. Acta Neuropathol 2024; 147:31. [PMID: 38310187 PMCID: PMC10838242 DOI: 10.1007/s00401-023-02678-7] [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: 09/05/2023] [Revised: 12/06/2023] [Accepted: 12/24/2023] [Indexed: 02/05/2024]
Abstract
Anti-glial fibrillary acidic protein (GFAP) meningoencephalomyelitis (autoimmune GFAP astrocytopathy) is a new autoimmune central nervous system (CNS) disease diagnosable by the presence of anti-GFAP autoantibodies in the cerebrospinal fluid and presents as meningoencephalomyelitis in the majority of patients. Only few neuropathological reports are available and little is known about the pathogenic mechanisms. We performed a histopathological study of two autopsies and nine CNS biopsies of patients with anti-GFAP autoantibodies and found predominantly a lymphocytic and in one autopsy case a granulomatous inflammatory phenotype. Inflammatory infiltrates were composed of B and T cells, including tissue-resident memory T cells. Although obvious astrocytic damage was absent in the GFAP-staining, we found cytotoxic T cell-mediated reactions reflected by the presence of CD8+/perforin+/granzyme A/B+ cells, polarized towards astrocytes. MHC-class-I was upregulated in reactive astrocytes of all biopsies and two autopsies but not in healthy controls. Importantly, we observed a prominent immunoreactivity of astrocytes with the complement factor C4d. Finally, we provided insight into an early phase of GFAP autoimmunity in an autopsy of a pug dog encephalitis that was characterized by marked meningoencephalitis with selective astrocytic damage with loss of GFAP and AQP4 in the lesions.Our histopathological findings indicate that a cytotoxic T cell-mediated immune reaction is present in GFAP autoimmunity. Complement C4d deposition on astrocytes could either represent the cause or consequence of astrocytic reactivity. Selective astrocytic damage is prominent in the early phase of GFAP autoimmunity in a canine autopsy case, but mild or absent in subacute and chronic stages in human disease, probably due to the high regeneration potential of astrocytes. The lymphocytic and granulomatous phenotypes might reflect different stages of lesion development or patient-specific modifications of the immune response. Future studies will be necessary to investigate possible implications of pathological subtypes for clinical disease course and therapeutic strategies.
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Affiliation(s)
- Yong Guo
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Verena Endmayr
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Anastasia Zekeridou
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
- Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Andrew McKeon
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
- Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein Kiel, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Katharina Hess
- Institute of Neuropathology, University Hospital Muenster, Muenster, North Rhine Westphalia, Germany
- Department of Pathology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Alicja Kalinowska-Lyszczarz
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznań, Poland
| | - Andrea Klang
- Institute of Pathology, University of Veterinary Medicine, Vienna, Austria
| | - Akos Pakozdy
- Internal Medicine, University Clinic for Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - Elisabeth Höftberger
- Internal Medicine, University Clinic for Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - Simon Hametner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Carmen Haider
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Désirée De Simoni
- Division of Neurology, Karl Landsteiner University of Health Sciences, University Hospital, St. Pölten, Austria
| | - Sönke Peters
- Clinic for Radiology and Neuroradiology, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Ellen Gelpi
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Christoph Röcken
- Department of Pathology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Stefan Oberndorfer
- Division of Neurology, Karl Landsteiner University of Health Sciences, University Hospital, St. Pölten, Austria
| | - Hans Lassmann
- Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | | | - Romana Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Jeffery N, Granger N. New insights into the treatment of meningoencephalomyelitis of unknown origin since 2009: A review of 671 cases. Front Vet Sci 2023; 10:1114798. [PMID: 37008358 PMCID: PMC10050685 DOI: 10.3389/fvets.2023.1114798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/17/2023] [Indexed: 03/17/2023] Open
Abstract
“Meningoencephalomyelitis of unknown origin” (MUO)—a collective term for a group of clinically-indistinguishable (but pathologically distinct) autoimmune diseases of the CNS—has become increasingly commonly recognized throughout the world. In the 1960s−1980s the focus was primarily on the pathological description of these conditions and, largely anecdotally, their response to glucocorticoids. The subsequent availability of magnetic resonance imaging for companion animals led to a focus on imaging characteristics and response of MUO to various immunosuppressive medications. Previous reviews have not found clear evidence of superiority of any specific treatment regimen. Here, we review outcomes in a further 671 dogs treated with various combinations of glucocorticoids and immunosuppressive drugs and reported since 2009, aiming to determine whether recommendations can be drawn from the material published during more recent decades. We observe that: (i) there is more complete information on outcome of MUO-affected dogs solely receiving glucocorticoids and these reports provide evidence to undermine the dogma that MUO inevitably requires treatment with glucocorticoids plus an immunosuppressive drug; (ii) there is far more information on the pharmacokinetics of cytarabine delivered by a variety of routes, revealing that previous dosing and duration of administration in dogs with MUO may not have been optimal; and, (iii) there is a large number of cases that could be available for entry into multi-institutional randomized controlled trials. Finally, we suggest new research avenues that might aid future clinical trials in MUO through improved understanding of etiological triggers and individual patterns of immune response, such as the impact of the gut microbiome, the potential of CSF flow cytometry, and the establishment of robust clinical scores for evaluation of treatment success.
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Affiliation(s)
- Nick Jeffery
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
- *Correspondence: Nick Jeffery
| | - Nicolas Granger
- Bristol Vet Specialists, CVS Referrals & Bristol Translational Health Sciences, University of Bristol, Bristol, United Kingdom
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OSHIMA A, ITO D, KATAKURA F, MIYAMAE J, OKANO M, NAKAZAWA M, KANAZONO S, MORITOMO T, KITAGAWA M. Dog leukocyte antigen class II alleles and haplotypes associated with meningoencephalomyelitis of unknown origin in Chihuahuas. J Vet Med Sci 2023; 85:62-70. [PMID: 36418080 PMCID: PMC9887217 DOI: 10.1292/jvms.22-0116] [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] [Indexed: 11/25/2022] Open
Abstract
Idiopathic non-infectious meningoencephalomyelitis (NIME), which is thought to be an immune-mediated disease, is a common inflammatory disease in dogs. Meningoencephalomyelitis of unknown origin (MUO), a subgroup of NIME, consists of necrotizing meningoencephalitis (NME), necrotizing leukoencephalitis, and granulomatous meningoencephalomyelitis. Recent studies have shown associations between disease development and dog leukocyte antigen (DLA) class II genes in NME in Pugs and in NIME in Greyhounds. This study focused on Chihuahuas, which have a high incidence of MUO and are one of the most common dog breeds in Japan. Because the development of MUO seems to be associated with DLA class II genes, we aimed to evaluate the association between DLA class II genes and MUO development in Chihuahuas. Blood samples were obtained from 22 Chihuahuas with MUO (MUO group) and 46 without neurological diseases (control). The allele sequences of three DLA class II loci were determined, and haplotypes were estimated from these data. In total, 23 haplotypes were detected. The frequency of one haplotype (DLA-DRB1*015:01--DQA1*006:01--DQB1*023:01) was significantly higher in the MUO group than in the control group (odds ratio, 7.11; 95% confidence interval, 1.37-36.81; P=0.0141). The results suggest that the development of MUO in Chihuahuas may be associated with DLA class II genes. Because the identified risk haplotypes differed from those of other breeds, the pathogenesis of NIME-related diseases may differ among dog breeds.
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Affiliation(s)
- Ayaka OSHIMA
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan
| | - Daisuke ITO
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan,Correspondence to: Ito D: , Laboratory of Veterinary Neurology, Department
of Veterinary Medicine, College of Bioresource Science, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Fumihiko KATAKURA
- Laboratory of Comparative Immunology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan
| | - Jiro MIYAMAE
- Faculty of Medicine, Okayama University of Science, Ehime, Japan
| | - Masaharu OKANO
- Department of Legal Medicine, Nihon University School of Dentistry, Tokyo, Japan
| | - Megu NAKAZAWA
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan
| | - Shinichi KANAZONO
- Neurology and Neurosurgery Service, Veterinary Specialists and Emergency Center, Saitama, Japan
| | - Tadaaki MORITOMO
- Laboratory of Comparative Immunology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan
| | - Masato KITAGAWA
- Laboratory of Veterinary Neurology, Department of Veterinary Medicine, College of Bioresource Science, Nihon University, Kanagawa, Japan
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Nessler JN, Oevermann A, Schawacht M, Gerhauser I, Spitzbarth I, Bittermann S, Steffen F, Schmidt MJ, Tipold A. Concomitant necrotizing encephalitis and granulomatous meningoencephalitis in four toy breed dogs. Front Vet Sci 2022; 9:957285. [PMID: 36118343 PMCID: PMC9477003 DOI: 10.3389/fvets.2022.957285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022] Open
Abstract
The term “meningoencephalitis of unknown origin” (MUO) describes a group of different encephalitides in dogs in which no infectious agent can be identified and a multifactorial etiology is suspected. Among others, genetic factors and unknown triggers seem to be involved. Included are necrotizing leukoencephalitis (NLE), necrotizing meningoencephalitis (NME), and granulomatous meningoencephalitis (GME). In this case series, we describe the histopathological findings of four toy breed dogs with focal or multifocal necrotizing encephalitis and mainly lymphocytic perivascular infiltrates on histopathological examination. At the same time, however, in all dogs, focal or multifocal high-grade angiocentric granulomatous inflammatory lesions were evident with focal histiocytic perivascular infiltrates in the brain. The former changes are typical for NLE and NME. In contrast, the latter changes are indicative of GME. This case series shows that the boundaries between the necrotizing and granulomatous variants of MUO might be smooth and suggests that NLE, NME, and GME are not as distinct as previously described. This finding could be a crucial piece of the puzzle in the study of the pathogenesis of MUO as individual susceptibility and specific triggers could be responsible for the manifestation of the different MUO subtypes.
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Affiliation(s)
- Jasmin Nicole Nessler
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
- *Correspondence: Jasmin Nicole Nessler
| | - Anna Oevermann
- Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Marina Schawacht
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Ingo Gerhauser
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Ingo Spitzbarth
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Sophie Bittermann
- Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Frank Steffen
- Department of Clinical Neurology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Martin Jürgen Schmidt
- Clinic for Small Animal-Surgery, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Germany
| | - Andrea Tipold
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Zdora I, Raue J, Söbbeler F, Tipold A, Baumgärtner W, Nessler JN. Case report: Lympho-histiocytic meningoencephalitis with central nervous system vasculitis of unknown origin in three dogs. Front Vet Sci 2022; 9:944867. [PMID: 36090171 PMCID: PMC9449415 DOI: 10.3389/fvets.2022.944867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Meningoencephalitis of unknown origin (MUO) is an umbrella term for a variety of subtypes of meningoencephalitis of dogs and cats with no identifiable infectious agent. In dogs, granulomatous meningoencephalitis (GME), necrotizing meningoencephalitis (NME), and necrotizing leukoencephalitis (NLE) are the most commonly reported subtypes. However, sporadically there are reports about other subtypes such as greyhound encephalitis or eosinophilic meningoencephalitis. The following case series presents three dogs with peracute to acute progressive signs of encephalopathy. The magnetic resonance imaging (MRI) of two dogs (post mortem n = 1/2) showed severe, diffuse swelling of the cortical gray matter with increased signal intensity in T2weighted (w) and fluid-attenuated inversion recovery (FLAIR) and decreased signal intensity in T1w. Additionally, focal to multifocal areas with signal void in both dogs and caudal transforaminal herniation of the cerebellum in one dog was observed. Post mortem histopathological examination revealed lympho-histiocytic encephalitis and central nervous system (CNS) vasculitis in all dogs. No infectious agents were detectable by histopathology (hematoxylin and eosin stain), periodic acid-Schiff reaction (PAS), Ziehl-Neelsen stain and immunohistochemistry for Canine adenovirus-1, Parvovirus, Listeria monocytogenes, Parainfluenzavirus, Toxoplasma gondii, Herpes-suis virus, Pan-Morbillivirus, Tick born encephalitis virus, Severe acute respiratory syndrome coronavirus (SARS-CoV) 2. Furthermore, two dogs were tested negative for rabies virus. To the best of the authors' knowledge, this is the first report of a lympho-histiocytic encephalitis with CNS vasculitis with no identifiable infectious agent. It is suggested to consider this as an additional subtype of MUO with severe clinical signs.
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Affiliation(s)
- Isabel Zdora
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
- Center of Systems Neuroscience, Hannover, Germany
| | - Jonathan Raue
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Franz Söbbeler
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Andrea Tipold
- Center of Systems Neuroscience, Hannover, Germany
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Wolfgang Baumgärtner
- Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany
- Center of Systems Neuroscience, Hannover, Germany
| | - Jasmin Nicole Nessler
- Department for Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
- *Correspondence: Jasmin Nicole Nessler
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Windsor R, Stewart S, Schmidt J, Mosqueda M, Piras I, Keller SM, Steinmetz B, Borjesson DL, Huentelman M, Khanna C. A potential early clinical phenotype of necrotizing meningoencephalitis in genetically at-risk pug dogs. J Vet Intern Med 2022; 36:1382-1389. [PMID: 35621070 PMCID: PMC9308433 DOI: 10.1111/jvim.16444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Necrotizing meningoencephalitis (NME) in the pug dogs is a fatal neuroinflammatory disease associated with rapid progression and poor response to conventional immunosuppressive therapy. Diagnosis is typically made after severe neurological abnormalities have manifested. HYPOTHESIS/OBJECTIVE Pug dogs at genetic risk for NME might manifest neurological abnormalities before developing pathognomonic clinical signs of NME. ANIMALS Thirty-six pug dogs less than 4 years of age asymptomatic for NME. METHODS Prospective observational cohort study with germline genome-wide genotyping. Neurological examinations were performed 4 weeks apart to document reproducible findings of central nervous system disease. Magnetic resonance imaging, cerebrospinal fluid analysis, and testing for infectious diseases were performed in all pugs with reproducible abnormalities detected on neurological examination. RESULTS The overall risk allele frequency in this cohort was 40%; 5 (14%) dogs were high risk, 19 (53%) dogs were medium risk, and 12 (33%) dogs were low genetic risk for NME. Reproducible abnormalities detected on neurological examination were identified in 8/24 (33%) genetically at-risk dogs and 0/12 (0%) low risk dogs. Clinical abnormalities included multifocal spinal pain in 8/8, reduced menace response in 5/8, and lateralizing postural reaction deficits in 5/8 pugs. There was a strong association between genotype risk and the presence of this clinical phenotype (P = .03). CONCLUSIONS AND CLINICAL IMPORTANCE Our findings suggest the presence of a novel early clinical phenotype of NME in apparently asymptomatic genetically at-risk pugs which might be used to plan early diagnostic and therapeutic clinical trials.
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Affiliation(s)
- Rebecca Windsor
- Ethos Veterinary HealthWoburnMassachusettsUSA
- Ethos Discovery (501c.3.)San DiegoCaliforniaUSA
| | - Samuel Stewart
- Ethos Veterinary HealthWoburnMassachusettsUSA
- Ethos Discovery (501c.3.)San DiegoCaliforniaUSA
| | | | - Mario Mosqueda
- Neurogenomics DivisionTranslational Genomics Research InstitutePhoenixArizonaUSA
| | - Ignazio Piras
- Neurogenomics DivisionTranslational Genomics Research InstitutePhoenixArizonaUSA
| | - Stefan M. Keller
- Department of Pathology, Microbiology, ImmunologyUniversity of California, DavisDavisCaliforniaUSA
| | - Briana Steinmetz
- Ethos Veterinary HealthWoburnMassachusettsUSA
- Ethos Discovery (501c.3.)San DiegoCaliforniaUSA
| | - Dori L. Borjesson
- Department of Pathology, Microbiology, ImmunologyUniversity of California, DavisDavisCaliforniaUSA
| | - Matthew Huentelman
- Neurogenomics DivisionTranslational Genomics Research InstitutePhoenixArizonaUSA
| | - Chand Khanna
- Ethos Veterinary HealthWoburnMassachusettsUSA
- Ethos Discovery (501c.3.)San DiegoCaliforniaUSA
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Nessler JN, Jo WK, Osterhaus ADME, Ludlow M, Tipold A. Canine Meningoencephalitis of Unknown Origin-The Search for Infectious Agents in the Cerebrospinal Fluid via Deep Sequencing. Front Vet Sci 2021; 8:645517. [PMID: 34950723 PMCID: PMC8688736 DOI: 10.3389/fvets.2021.645517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 11/15/2021] [Indexed: 01/02/2023] Open
Abstract
Meningoencephalitis of unknown origin (MUO) describes a group of meningoencephalitides in dogs with a hitherto unknown trigger. An infectious agent has been suggested as one possible trigger of MUO but has not been proven so far. A relatively new method to screen for viral RNA or DNA is next-generation sequencing (NGS) or deep sequencing. In this study, a metagenomics analysis of the virome in a sample is analyzed and scanned for known or unknown viruses. We examined fresh-frozen CSF of 6 dogs with MUO via NGS using a modified sequence-independent, single-primer amplification protocol to detect a possible infectious trigger. Analysis of sequencing reads obtained from the six CSF samples showed no evidence of a virus infection. The inability to detect a viral trigger which could be implicated in the development of MUO in the examined population of European dogs, suggests that the current techniques are not sufficiently sensitive to identify a possible virus infection, that the virus is already eliminated at the time-point of disease outbreak, the trigger might be non-infectious or that there is no external trigger responsible for initiating MUO in dogs.
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Affiliation(s)
- Jasmin Nicole Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Wendy Karen Jo
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Albert D M E Osterhaus
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Martin Ludlow
- Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine Foundation, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hannover, Germany
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10
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Windsor R, Stewart SD, Talboom J, Lewis C, Naymik M, Piras IS, Keller S, Borjesson DL, Clark G, Khanna C, Huentelman M. Leukocyte and cytokine variables in asymptomatic Pugs at genetic risk of necrotizing meningoencephalitis. J Vet Intern Med 2021; 35:2846-2852. [PMID: 34687084 PMCID: PMC8692191 DOI: 10.1111/jvim.16293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 10/10/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Necrotizing meningoencephalitis (NME, aka Pug dog encephalitis) is an inflammatory brain condition associated with advanced disease at initial presentation, rapid progression, and poor response to conventional immunomodulatory therapy. HYPOTHESIS/OBJECTIVES That genetic risk for NME, defined by a common germline DNA haplotype located on chromosome 12, is associated with altered blood cytokine concentrations and leukocyte subsets in asymptomatic Pugs. ANIMALS Forty Pug dogs asymptomatic for NME from a hospital sample. METHODS Prospective observational cohort study, including germline genome-wide genotyping, plasma cytokine determination by multiplexed profiling, and leukocyte subset characterization by flow cytometric analysis. RESULTS Seven (18%) dogs were high risk, 10 (25%) medium risk, and 23 (58%) low risk for NME, giving a risk haplotype frequency of 30%. High and medium risk Pugs had significantly lower proportion of CD4+ T cells (median 22% [range, 7.3%-38%] vs 29% [range, 16%-41%], P = .03) and higher plasma IL-10 concentrations than low-risk Pugs (median 14.11 pg/mL [range, 9.66-344.19 pg/mL] vs 12.21 pg/mL [range, 2.59-18.53 pg/mL], P = .001). No other variables were significantly associated with the NME haplotype-based risk. CONCLUSIONS AND CLINICAL IMPORTANCE These data suggest an immunological underpinning to NME and a biologic rationale for future clinical trials that investigate novel diagnostic, preventative, and therapeutic strategies for this disease.
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Affiliation(s)
- Rebecca Windsor
- Ethos Veterinary Health, Woburn, Massachusetts, USA.,Ethos Discovery (501c3), San Diego, California, USA
| | - Samuel D Stewart
- Ethos Veterinary Health, Woburn, Massachusetts, USA.,Ethos Discovery (501c3), San Diego, California, USA
| | - Joshua Talboom
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Candace Lewis
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Marcus Naymik
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Ignazio S Piras
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Stefan Keller
- Department of Pathology, Microbiology, Immunology, University of California, Davis, Davis, California, USA
| | - Dori L Borjesson
- Department of Pathology, Microbiology, Immunology, University of California, Davis, Davis, California, USA
| | - Gary Clark
- Gary Clark Statistical Consulting LLC, Superior, Colorado, USA
| | - Chand Khanna
- Ethos Veterinary Health, Woburn, Massachusetts, USA.,Ethos Discovery (501c3), San Diego, California, USA
| | - Matthew Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
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11
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Buhmann G, Wielaender F, Rosati M, Matiasek K, Hartmann K, Fischer A. [Canine meningoencephalitis and meningitis: retrospective analysis of a veterinary hospital population]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2020; 48:233-244. [PMID: 32823346 DOI: 10.1055/a-1186-8051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Characterization of the etiology of meningoencephalitis and meningitis in dogs through an analysis of a veterinary hospital population. MATERIAL AND METHODS Retrospective study (2011-2016) with evaluation of clinical and diagnostic data of dogs with cerebrospinal fluid (CSF) pleocytosis (> 5/µl). Only dogs with cytological evaluation of CSF or pathological examination of CNS were included. Results of CSF cytology and examination for infectious diseases were reviewed. RESULTS A total of 62 dogs met the inclusion criteria. 14.5 % (n = 9) were classified as reactive CSF pleocytosis due to other structural CNS disease, such as neoplasia or infarct. Meningoencephalitis or meningitis of unknown origin was diagnosed in 56.5 % (n = 35). In 29.0 % (n = 18), investigations for infectious diseases or presence of bacteria in CSF cytology (n = 5) indicated an infectious etiology. This infectious etiology appeared reliable in 6 dogs (9.7 %) based on the examination findings, in 9 dogs (14.5 %), there was only a suspicion of infectious meningoencephalitis or meningitis and in 3 dogs (4.8 %), the findings were of uncertain significance. CONCLUSION The most common cause of CSF pleocytosis was meningoencephalitis or meningitis of unknown origin. Nevertheless, there was evidence of a possible infectious etiology in 29 % of the dogs. For a reliable diagnosis, it is important to assess the CSF cytology and to conduct investigations for infectious diseases. CLINICAL RELEVANCE Meningoencephalitis or meningitis of unknown origin requires immunosuppressive therapy. Therefore, CSF cytology and investigations for infectious diseases are important for an exclusion of infectious meningoencephalitis or meningitis.
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Affiliation(s)
- Gesine Buhmann
- Medizinische Kleintierklinik, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
| | - Franziska Wielaender
- Medizinische Kleintierklinik, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
| | - Marco Rosati
- Sektion für Klinische und Vergleichende Neuropathologie, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
| | - Kaspar Matiasek
- Sektion für Klinische und Vergleichende Neuropathologie, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
| | - Katrin Hartmann
- Medizinische Kleintierklinik, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
| | - Andrea Fischer
- Medizinische Kleintierklinik, Zentrum für Klinische Tiermedizin der Ludwig-Maximilians-Universität München
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12
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Brady SL, Woodward AP, le Chevoir M. Survival time and relapse in dogs with meningoencephalomyelitis of unknown origin treated with prednisolone and ciclosporin: a retrospective study. Aust Vet J 2020; 98:491-498. [PMID: 32794230 DOI: 10.1111/avj.12994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To analyse outcome in dogs with a presumptive diagnosis of meningoencephalomyelitis of unknown origin (MUO) treated with prednisolone and ciclosporin and to assess the effect of a number of patient variables on survival time and rate of relapse. DESIGN Retrospective case series. METHODS Medical records of 40 client-owned dogs with a diagnosis of MUO treated with prednisolone and ciclosporin at one institution between June 2010 and January 2018 were reviewed retrospectively to assess survival times and prognostic indicators for death and/or relapse. The minimum follow-up time was 11 months post-diagnosis. RESULTS Median survival was 1345 days (95% confidence interval: 487-∞). No associations with hazard of death or relapse were detected for the presence of multifocal magnetic resonance imaging (MRI) abnormalities, caudal fossa location of MRI abnormalities, value of cerebrospinal fluid total nucleated cell count or total protein at time of diagnosis, or suspected elevation in intracranial pressure at time of diagnosis. CONCLUSION Protracted survival time may be achieved with a treatment combination of prednisolone and ciclosporin. Suspected elevation in intracranial pressure at the time of diagnosis did not affect long-term outcome in this cohort.
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Affiliation(s)
- S L Brady
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia.,The Queen's Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom
| | - A P Woodward
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia
| | - Mar le Chevoir
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia.,Veterinary Emergency and Specialty Hospital, Singapore
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13
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Barnes Heller HL, Granick MN, Pinkerton ME, Keuler NS. Case-control study of risk factors for granulomatous meningoencephalomyelitis in dogs. J Am Vet Med Assoc 2020; 254:822-825. [PMID: 30888272 DOI: 10.2460/javma.254.7.822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify environmental and other variables associated with a diagnosis of granulomatous meningoencephalomyelitis (GME) in dogs. DESIGN Case-control study. ANIMALS 31 dogs that received a histologic diagnosis of GME (case dogs) from January 2003 to January 2014 and 91 age- and breed-matched dogs. PROCEDURES Data were obtained from each dog's medical records regarding home address, signalment, body weight, body condition score (BCS), vaccination history, and date of diagnosis (case dogs) or visit (control dogs). Home address data were used to determine the human population density in each dog's geographic region. Seasonal distributions of GME diagnoses in the case group were evaluated for differences. Case and control dogs were compared with respect to the remaining variables. RESULTS For case dogs, no significant difference was identified among seasons in the distribution of GME diagnoses; however, such diagnoses were more common in the spring than in other seasons. No significant differences were identified between case and control dogs in age, body weight, BCS, human population density, season of diagnosis or visit, or time of last vaccination. Although females appeared more likely than males to have a GME diagnosis, this association was not significant and did not change when BCS, time since last vaccination, or human population density was considered. CONCLUSIONS AND CLINICAL RELEVANCE None of the evaluated factors, including investigated environmental triggers, were associated with a GME diagnosis in the dogs of this study. Additional research is warranted involving dogs from a broader geographic area.
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14
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Nessler J, Wohlsein P, Junginger J, Hansmann F, Erath J, Söbbeler F, Dziallas P, Tipold A. Meningoencephalomyelitis of Unknown Origin in Cats: A Case Series Describing Clinical and Pathological Findings. Front Vet Sci 2020; 7:291. [PMID: 32671104 PMCID: PMC7326087 DOI: 10.3389/fvets.2020.00291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/29/2020] [Indexed: 12/02/2022] Open
Abstract
Meningoencephalomyelitis of unknown origin (MUO) is an umbrella term describing inflammatory changes of the central nervous system (CNS) with suspected non-infectious etiology. Diagnosis of MUO mostly remains presumed in a clinical setting. Histopathological and immunohistochemical examination of CNS tissue represent additional tools for detection of inflammation and the exclusion of specific infectious agents. While MUO is well-described in canine patients, only little is known about MUO in cats. Previous reports of feline MUO involve either clinical findings or histopathological examination but not both. The present case series is the first report describing both clinical and histopathological findings of feline MUO: Four cats (age: 1.7–17.8 years) showed acute to chronic progressive neurological signs of encephalopathy or myelopathy. Three cats had extraneural signs (hyperthermia, weight loss, hyporexia, leukocytosis). Magnetic resonance imaging (MRI) showed multifocal intraparenchymal lesions in forebrain, brainstem or spinal cord with homogenous contrast enhancement (2/2). Cerebrospinal fluid (CSF) examination was normal or displayed albuminocytologic dissociation. Histopathology revealed a multifocal, lympho-histiocytic meningoencephalitis in three cases and a lympho-histiocytic myelitis in one case. Immunohistochemistry for feline parvovirus, feline coronavirus, feline herpesvirus, tick borne encephalitis virus, Borna disease virus, morbillivirus, rabies virus, suid herpesvirus-1, and Toxoplasma gondii were negative in all cases.
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Affiliation(s)
- Jasmin Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Peter Wohlsein
- Department of Pathology, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Johannes Junginger
- Department of Pathology, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Florian Hansmann
- Department of Pathology, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Johannes Erath
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Franz Söbbeler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Peter Dziallas
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hanover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Foundation, Hanover, Germany
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15
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Posporis C, Beltran E, Dunning M, Espadas I, Gillespie S, Barry AT, Wessmann A. Prognostic Factors for Recovery of Vision in Canine Optic Neuritis of Unknown Etiology: 26 Dogs (2003-2018). Front Vet Sci 2019; 6:415. [PMID: 31824972 PMCID: PMC6882734 DOI: 10.3389/fvets.2019.00415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/07/2019] [Indexed: 12/03/2022] Open
Abstract
Optic neuritis (ON) is a recognized condition, yet factors influencing recovery of vision are currently unknown. The purpose of this study was to identify prognostic factors for recovery of vision in canine ON of unknown etiology. Clinical databases of three referral hospitals were searched for dogs with presumptive ON based on clinicopathologic, MRI/CT, and fundoscopic findings. Twenty-six dogs diagnosed with presumptive ON of unknown etiology, isolated (I-ON) and MUE-associated (MUE-ON), were included in the study. Their medical records were reviewed retrospectively, and the association of complete recovery of vision with signalment, clinicopathologic findings, and treatment was investigated. Datasets were tested for normality using the D'Agostino and Shapiro-Wilk tests. Individual datasets were compared using the Chi-squared test, Fisher's exact test, and the Mann-Whitney U-test. For multiple comparisons with parametric datasets, the one-way analysis of variance (ANOVA) was performed, and for non-parametric datasets, the Kruskal-Wallis test was performed to test for independence. For all data, averages are expressed as median with interquartile range and significance set at p < 0.05. Twenty-six dogs met the inclusion criteria. Median follow-up was 230 days (range 21–1901 days, mean 496 days). Six dogs (23%) achieved complete recovery and 20 dogs (77%) incomplete or no recovery of vision. The presence of a reactive pupillary light reflex (p = 0.013), the absence of fundoscopic lesions (p = 0.0006), a younger age (p = 0.038), and a lower cerebrospinal fluid (CSF) total nucleated cell count (TNCC) (p = 0.022) were statistically associated with complete recovery of vision. Dogs with I-ON were significantly younger (p = 0.046) and had lower CSF TNCC (p = 0.030) compared to the MUE-ON group. This study identified prognostic factors that may influence complete recovery of vision in dogs with ON. A larger cohort of dogs is required to determine whether these findings are robust and whether additional parameters aid accurate prognosis for recovery of vision in canine ON.
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Affiliation(s)
| | - Elsa Beltran
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, United Kingdom
| | - Mark Dunning
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, United Kingdom.,Willows Veterinary Centre and Referral Service, Shirley, United Kingdom
| | - Irene Espadas
- Neurology/Neurosurgery Service, Pride Veterinary Centre, Derby, United Kingdom.,Small Animal Teaching Hospital, School of Veterinary Sciences, University of Liverpool, Neston, United Kingdom
| | - Sabrina Gillespie
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, United Kingdom
| | - Amy Teresa Barry
- Queen Mother Hospital for Animals, Royal Veterinary College, Hatfield, United Kingdom
| | - Annette Wessmann
- Neurology/Neurosurgery Service, Pride Veterinary Centre, Derby, United Kingdom
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16
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Vitale S, Foss K. Immune-Mediated Central Nervous System Disease-Current Knowledge and Recommendations. Top Companion Anim Med 2019; 34:22-29. [PMID: 30808493 PMCID: PMC7185457 DOI: 10.1053/j.tcam.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/10/2018] [Accepted: 11/29/2018] [Indexed: 01/05/2023]
Abstract
Immune-mediated inflammation is responsible for about 25% of central nervous system disease in dogs. The disease can affect all ages and breeds, but young to middle-aged small breed dogs are over-represented for most forms. Diagnosis consists of advanced imaging (MRI), cerebrospinal fluid analysis, and infectious disease testing, but biopsy is required for definitive diagnosis and classification of the disease into one of the many subtypes. Treatment consists of immunosuppressive medication with the goal being to control and/or improve clinical signs. Current literature shows that prognosis is variable.
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Affiliation(s)
- Samantha Vitale
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL, USA.
| | - Kari Foss
- Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL, USA
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17
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Abstract
There are many autoimmune diseases that are recognized in domestic animals. The descriptions of diseases provide examples of the magnitude of immune targets and the variable nature of autoimmune diseases. Other autoimmune diseases that are recognized in dogs, cats, and horses include immune-mediated thrombocytopenia, VKH (Vogt-Koyanagi-Harada) ocular disease (dogs), and Evans syndrome (which includes both immune-mediated anemia and immune-mediated thrombocytopenia).
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18
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Jeffery ND, Barker AK, Alcott CJ, Levine JM, Meren I, Wengert J, Jergens AE, Suchodolski JS. The Association of Specific Constituents of the Fecal Microbiota with Immune-Mediated Brain Disease in Dogs. PLoS One 2017; 12:e0170589. [PMID: 28125651 PMCID: PMC5268494 DOI: 10.1371/journal.pone.0170589] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/06/2017] [Indexed: 12/12/2022] Open
Abstract
Meningoencephalomyelitis of unknown origin (MUO) is a common, naturally-occurring, clinical disease of pet dogs. It is an immune-mediated condition that has many similarities with experimental autoimmune encephalitis (EAE) in rodents and so investigation of its pathogenesis may aid in understanding factors that contribute to development of multiple sclerosis in people. Gut microbiota are known to modulate immune responses that influence susceptibility to immune-mediated brain disease. In this study we aimed to compare abundance of specific constituents of the fecal microbiota, namely Faecalibacterium prausnitzii and Prevotellaceae, between dogs diagnosed with MUO and matched controls. Fecal samples were obtained from 20 dogs diagnosed with MUO and 20 control dogs matched for breed, age and gender. Bacterial abundance was measured using qPCR and 16S rRNA sequencing. We found that Prevotellaceae were significantly less abundant in cases compared with controls (p = 0.003) but there was no difference in abundance of F.prausnitzii. There was no evidence of other differences in gut microbiota between groups. These data, derived from this naturally-occurring canine clinical model, provide strong corroborative evidence that high abundance of Prevotellaceae in the gut is associated with reduced risk for developing immune-mediated brain disease.
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Affiliation(s)
- Nick D. Jeffery
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Andrew K. Barker
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Cody J. Alcott
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Jon M. Levine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United State of America
| | - Ilyssa Meren
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Jane Wengert
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Albert E. Jergens
- Department of Veterinary Clinical Studies, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United State of America
| | - Jan S. Suchodolski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United State of America
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19
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Oliphant BJ, Barnes Heller HL, White JM. RETROSPECTIVE STUDY EVALUATING ASSOCIATIONS BETWEEN MIDLINE BRAIN SHIFT ON MAGNETIC RESONANCE IMAGING AND SURVIVAL IN DOGS DIAGNOSED WITH MENINGOENCEPHALITIS OF UNKNOWN ETIOLOGY. Vet Radiol Ultrasound 2016; 58:38-43. [PMID: 27774741 DOI: 10.1111/vru.12434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 08/31/2016] [Accepted: 09/04/2016] [Indexed: 12/01/2022] Open
Abstract
Difficulty has been encountered when trying to identify ante mortem prognostic indicators for dogs with meningoencephalitis of unknown etiology (MUE). Identifying MRI imaging parameters associated with prognosis may impact treatment decision-making for clinician and owner. Our hypotheses for this retrospective cohort study are that dogs diagnosed with MUE that had midline shift on brain MRI would have a poorer survival compared to dogs without midline shift; and that younger age, lower weight, and low cerebrospinal fluid (CSF) cell count would be correlated with improved survival. Medical records were reviewed from two institutions. Inclusion criteria included: clinical signs referable to intracranial disease, brain MRI at presentation, abnormal CSF analysis, and negative infectious disease testing. Magnetic resonance imaging scans were evaluated for midline shift using the T2-weighted transverse image at the interthalamic adhesion and at the site of maximal deviation. Fifty-two dogs met the inclusion criteria. Median midline deviation was 0.12 cm. Median survival for dogs with no shift was 906 days and with shift was 84 days. Survival was not significantly different between groups (P = 0.11). This remained true when correcting for age (P = 0.22) and CSF TNCC (total nucleated cell count) (P = 0.12). Age at the time of diagnosis (P = 0.02) and CSF TNCC (P = 0.03) were significantly associated with survival. Cerebrospinal fluid protein value (P = 0.84) and weight (P = 0.82) were not significantly associated with survival. In this study of 52 dogs with MUE, MRI evidence of midline brain shift between 0.04 and 0.3 cm at the level of the interthalamic adhesion was not associated with shorter survival.
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Affiliation(s)
- Bonnie J Oliphant
- Department of Medical Sciences, University of Wisconsin, Madison, WI, 53706
| | | | - Jennifer M White
- Department of Veterinary Specialty and Emergency Hospital, San Diego, CA, 92121
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20
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Uchida K, Park E, Tsuboi M, Chambers JK, Nakayama H. Pathological and immunological features of canine necrotising meningoencephalitis and granulomatous meningoencephalitis. Vet J 2016; 213:72-7. [DOI: 10.1016/j.tvjl.2016.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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21
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Friedenberg SG, Buhrman G, Chdid L, Olby NJ, Olivry T, Guillaumin J, O'Toole T, Goggs R, Kennedy LJ, Rose RB, Meurs KM. Evaluation of a DLA-79 allele associated with multiple immune-mediated diseases in dogs. Immunogenetics 2015; 68:205-17. [PMID: 26711123 DOI: 10.1007/s00251-015-0894-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/18/2015] [Indexed: 11/30/2022]
Abstract
Immune-mediated diseases are common and life-threatening disorders in dogs. Many canine immune-mediated diseases have strong breed predispositions and are believed to be inherited. However, the genetic mutations that cause these diseases are mostly unknown. As many immune-mediated diseases in humans share polymorphisms among a common set of genes, we conducted a candidate gene study of 15 of these genes across four immune-mediated diseases (immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, immune-mediated polyarthritis (IMPA), and atopic dermatitis) in 195 affected and 206 unaffected dogs to assess whether causative or predictive polymorphisms might exist in similar genes in dogs. We demonstrate a strong association (Fisher's exact p = 0.0004 for allelic association, p = 0.0035 for genotypic association) between two polymorphic positions (10 bp apart) in exon 2 of one allele in DLA-79, DLA-79*001:02, and multiple immune-mediated diseases. The frequency of this allele was significantly higher in dogs with immune-mediated disease than in control dogs (0.21 vs. 0.12) and ranged from 0.28 in dogs with IMPA to 0.15 in dogs with atopic dermatitis. This allele has two non-synonymous substitutions (compared with the reference allele, DLA-79*001:01), resulting in F33L and N37D amino acid changes. These mutations occur in the peptide-binding pocket of the protein, and based upon our computational modeling studies, are likely to affect critical interactions with the peptide N-terminus. Further studies are warranted to confirm these findings more broadly and to determine the specific mechanism by which the identified variants alter canine immune system function.
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Affiliation(s)
- Steven G Friedenberg
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA. .,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27607, USA.
| | - Greg Buhrman
- Department of Molecular and Structural Biochemistry, North Carolina State University, Raleigh, NC, 27695, USA
| | - Lhoucine Chdid
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27607, USA
| | - Thierry Olivry
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27607, USA
| | - Julien Guillaumin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Theresa O'Toole
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, 01536, USA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Lorna J Kennedy
- Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, UK, M13 9PT
| | - Robert B Rose
- Department of Molecular and Structural Biochemistry, North Carolina State University, Raleigh, NC, 27695, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27607, USA
| | - Kathryn M Meurs
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27607, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, 27607, USA
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22
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Tipold A. Grand Challenge Veterinary Neurology and Neurosurgery: Veterinary Neurology and Neurosurgery - Research for Animals and Translational Aspects. Front Vet Sci 2015; 2:13. [PMID: 26664942 PMCID: PMC4672178 DOI: 10.3389/fvets.2015.00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/07/2015] [Indexed: 11/30/2022] Open
Affiliation(s)
- Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover , Hannover , Germany
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23
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Pedersen NC, Liu H, Leonard A, Griffioen L. A search for genetic diversity among Italian Greyhounds from Continental Europe and the USA and the effect of inbreeding on susceptibility to autoimmune disease. Canine Genet Epidemiol 2015; 2:17. [PMID: 26526059 PMCID: PMC4628233 DOI: 10.1186/s40575-015-0030-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/15/2015] [Indexed: 12/22/2022] Open
Abstract
Background Previous studies documented the problem of inbreeding among Italian Greyhounds (IG) from the USA and its possible role in a multiple autoimmune disease syndrome. The present study is an extension of these earlier experiments and had two objectives: 1) to identify pockets of additional genetic diversity that might still exist among IG from the USA and Continental Europe, and 2) to determine how loss of genetic diversity within the genome and in the dog leukocyte antigen (DLA) complex relates to the problem of autoimmune disease in IG from the USA. Genetic testing was conducted using 33 short tandem repeat (STR) loci across 25 chromosomes and 7 STR loci that associated with specific dog leukocyte antigen (DLA) class I and II haplotypes. Standard genetic assessment tests based on allele frequencies and internal relatedness (IR) were used as measures of breed-wide and individual heterozygosity. Results The results of these tests demonstrated that IG from the USA and Continental Europe belonged to a single breed but were genetically distinguishable by genomic allele frequencies, DLA class I and II haplotypes, and principal coordinate analysis (PCoA). In the second part of the study, 85 IG from the USA that had suffered various autoimmune disorders (case) and 104 healthy dogs (control) of comparable age were studied for genetic associations with disease. Case dogs were found to be significantly more homozygous in the DLA regions than control dogs. Principal coordinate analysis did not differentiate case from control populations. No specific STR-associated DLA-class I or II haplotype was associated with increased autoimmune disease risks. Reasons for the loss of genetic diversity and increased homozygosity among IG from the USA were studied using registration data and deep pedigrees. The breed in the USA started from a small number of founders from Europe and has remained relatively isolated and small in numbers, limiting breeding choices especially in the period before modern transportation and artificial insemination. An additional cause of lost diversity and increased homozygosity has been the influence of famous sires and their show-winning progeny. The most influential of these sires was Ch. Dasa’s King of the Mountain (King) born in 1978. Virtually all contemporary IG from the USA have King at least once in 10 generation pedigrees and 18 % of the genome of contemporary IG from the USA is shared with King. Conclusions It was concluded that artificial genetic bottlenecks have concentrated numerous genetic polymorphisms responsible for autoimmune disease and that these risk factors did not originate in a specific individual or bloodline of the breed. Rather, they were of ancestral origin in both purebred and random bred dogs and inherited by descent. Italian Greyhound breeders in the USA have several options to improve breed health: 1) breed against homozygosity within the genome and in the DLA region, 2) avoid breeding dogs that have suffered an autoimmune disorder, 3) increase diversity by incorporating the genetic differences that exist in IG from Continental Europe, or 4) outcross to other small sighthound breeds. The latter two approaches must be undertaken with care to avoid introduction of new deleterious traits and to maximize retention and dissemination of new genetic diversity.
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Affiliation(s)
- Niels C Pedersen
- Center for Companion Animal Health, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616 USA
| | - Hongwei Liu
- Center for Companion Animal Health, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616 USA
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