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Kruse CJ, Dieu M, Renaud B, François AC, Stern D, Demazy C, Burteau S, Boemer F, Art T, Renard P, Votion DM. New Pathophysiological Insights from Serum Proteome Profiling in Equine Atypical Myopathy. ACS OMEGA 2024; 9:6505-6526. [PMID: 38371826 PMCID: PMC10870397 DOI: 10.1021/acsomega.3c06647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/15/2023] [Accepted: 12/29/2023] [Indexed: 02/20/2024]
Abstract
Equine atypical myopathy (AM) is a severe environmental intoxication linked to the ingestion of protoxins contained in seeds and seedlings of the sycamore maple (Acer pseudoplatanus) in Europe. The toxic metabolites cause a frequently fatal rhabdomyolysis syndrome in grazing horses. Since these toxic metabolites can also be present in cograzing horses, it is still unclear as to why, in a similar environmental context, some horses show signs of AM, whereas others remain clinically healthy. Label-free proteomic analyses on the serum of 26 diseased AM, 23 cograzers, and 11 control horses were performed to provide insights into biological processes and pathways. A total of 43 and 44 differentially abundant proteins between "AM vs cograzing horses" and "AM vs control horses" were found. Disease-linked changes in the proteome of different groups were found to correlate with detected amounts of toxins, and principal component analyses were performed to identify the 29 proteins representing a robust AM signature. Among the pathway-specific changes, the glycolysis/gluconeogenesis pathway, the coagulation/complement cascade, and the biosynthesis of amino acids were affected. Sycamore maple poisoning results in a combination of inflammation, oxidative stress, and impaired lipid metabolism, which is trying to be counteracted by enhanced glycolysis.
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Affiliation(s)
- Caroline-J. Kruse
- Department
of Functional Sciences, Faculty of Veterinary Medicine, Physiology
and Sport Medicine, Fundamental and Applied
Research for Animals & Health (FARAH), University of Liège, Sart Tilman, 4000 Liège 1, Belgium
| | - Marc Dieu
- Namur
Research Institute for Life Sciences (Narilis), University of Namur (UNamur), Namur 5000, Belgium
- MaSUN,
Mass Spectrometry Facility, University of
Namur (UNamur), Namur 5000, Belgium
| | - Benoît Renaud
- Department
of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology
and Toxicology, Fundamental and Applied
Research for Animals & Health (FARAH), University of Liège, Sart Tilman, 4000 Liège 1, Belgium
| | - Anne-Christine François
- Department
of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology
and Toxicology, Fundamental and Applied
Research for Animals & Health (FARAH), University of Liège, Sart Tilman, 4000 Liège 1, Belgium
| | - David Stern
- GIGA
Bioinformatics Platform, GIGA Institute, University of Liège, Sart Tilman, 4000 Liège, Belgium
| | - Catherine Demazy
- Namur
Research Institute for Life Sciences (Narilis), University of Namur (UNamur), Namur 5000, Belgium
- MaSUN,
Mass Spectrometry Facility, University of
Namur (UNamur), Namur 5000, Belgium
| | - Sophie Burteau
- Namur
Research Institute for Life Sciences (Narilis), University of Namur (UNamur), Namur 5000, Belgium
- MaSUN,
Mass Spectrometry Facility, University of
Namur (UNamur), Namur 5000, Belgium
| | - François Boemer
- Biochemical
Genetics Lab, Department of Human Genetics, CHU of Liège, University of Liège, Sart Tilman, 4000 Liège, Belgium
| | - Tatiana Art
- Department
of Functional Sciences, Faculty of Veterinary Medicine, Physiology
and Sport Medicine, Fundamental and Applied
Research for Animals & Health (FARAH), University of Liège, Sart Tilman, 4000 Liège 1, Belgium
| | - Patricia Renard
- Namur
Research Institute for Life Sciences (Narilis), University of Namur (UNamur), Namur 5000, Belgium
- MaSUN,
Mass Spectrometry Facility, University of
Namur (UNamur), Namur 5000, Belgium
| | - Dominique-M. Votion
- Department
of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology
and Toxicology, Fundamental and Applied
Research for Animals & Health (FARAH), University of Liège, Sart Tilman, 4000 Liège 1, Belgium
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Sander J, Terhardt M, Janzen N, Renaud B, Kruse CJ, François AC, Wouters CP, Boemer F, Votion DM. Tissue Specific Distribution and Activation of Sapindaceae Toxins in Horses Suffering from Atypical Myopathy. Animals (Basel) 2023; 13:2410. [PMID: 37570219 PMCID: PMC10417358 DOI: 10.3390/ani13152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
Equine atypical myopathy is caused by hypoglycin A (HGA) and methylenecyclopropylglycine (MCPrG), the known protoxins of sycamore maple (Acer pseudoplatanus). Various tissues from five atypical myopathy cases were analyzed but only HGA was found. Whether deamination of MCPrG has already occurred in the intestine as the first stage of metabolization has not been investigated. Activation of the protoxins to methylenecyclopropylacetyl (MCPA)-CoA and methylenecyclopropylformyl (MCPF)-CoA, respectively, occurred mainly in the skeletal muscles, as evidenced by very high concentrations of MCPA-carnitine and MCPF-carnitine in this tissue. Inhibition of the acyl-CoA dehydrogenases of short- and medium-chain as well as branched-chain fatty acids by the toxins led to a strong increase in the corresponding acylcarnitines, again preferentially in skeletal muscles. An accumulation of the long-chain acylcarnitines beyond the level of the control samples could not be detected in the tissues. As a high amount of HGA was always found unmetabolized in the organs, we speculate that targeting the interruption of further metabolization might be a way to stop the progression of intoxication. Inhibition of the mitochondrial branched-chain amino acid aminotransferase, i.e., the first enzyme responsible for the activation of sycamore maple protoxins, could be a therapeutic approach.
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Affiliation(s)
- Johannes Sander
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
- Department of Clinical Chemistry, Hanover Medical School, 30625 Hanover, Germany
| | - Michael Terhardt
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
| | - Nils Janzen
- Screening-Labor Hannover, 30952 Ronnenberg, Germany; (M.T.); (N.J.)
- Department of Clinical Chemistry, Hanover Medical School, 30625 Hanover, Germany
| | - Benoît Renaud
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - Caroline-Julia Kruse
- Department of Functional Sciences, Physiology and Sport Medicine, Faculty of Veterinary Medicine, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium;
| | - Anne-Christine François
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - Clovis P. Wouters
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetics, CHU Sart Tilman, University of Liège, 4000 Liège, Belgium;
| | - Dominique-Marie Votion
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège, Belgium; (B.R.); (A.-C.F.); (C.P.W.); (D.-M.V.)
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Wouters CP, Toquet MP, Renaud B, François AC, Fortier-Guillaume J, Marcillaud-Pitel C, Boemer F, De Tullio P, Richard EA, Votion DM. Metabolomic Signatures Discriminate Horses with Clinical Signs of Atypical Myopathy from Healthy Co-grazing Horses. J Proteome Res 2021; 20:4681-4692. [PMID: 34435779 DOI: 10.1021/acs.jproteome.1c00225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Atypical myopathy (AM) is a severe rhabdomyolysis syndrome that occurs in grazing horses. Despite the presence of toxins in their blood, all horses from the same pasture are not prone to display clinical signs of AM. The objective of this study was to compare the blood metabolomic profiles of horses with AM clinical signs with those of healthy co-grazing (Co-G) horses. To do so, plasma samples from 5 AM horses and 11 Co-G horses were investigated using untargeted metabolomics. Metabolomic data were evaluated using unsupervised, supervised, and pathway analyses. Unsupervised principal component analysis performed with all detected features separated AM and healthy Co-G horses. Supervised analyses had identified 1276 features showing differential expression between both groups. Among them, 46 metabolites, belonging predominantly to the fatty acid, fatty ester, and amino acid chemical classes, were identified by standard comparison. Fatty acids, unsaturated fatty acids, organic dicarboxylic acids, and fatty esters were detected with higher intensities in AM horses in link with the toxins' pathological mechanism. The main relevant pathways were lipid metabolism; valine, leucine, and isoleucine metabolism; and glycine metabolism. This study revealed characteristic metabolite changes in the plasma of clinically affected horses, which might ultimately help scientists and field veterinarians to detect and manage AM. The raw data of metabolomics are available in the MetaboLights database with the access number MTBLS2579.
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Affiliation(s)
- Clovis P Wouters
- LABÉO (Frank Duncombe), 1 route de Rosel, 14053 Caen Cedex 4, France.,Normandie Université, UniCaen, EA7450 Biotargen, 3 rue Nelson Mandela, 14280 Saint-Contest, France.,Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium.,Pommier-Nutrition, 28170 Châteauneuf-en-Thymerais, France
| | - Marie-Pierre Toquet
- LABÉO (Frank Duncombe), 1 route de Rosel, 14053 Caen Cedex 4, France.,Normandie Université, UniCaen, EA7450 Biotargen, 3 rue Nelson Mandela, 14280 Saint-Contest, France
| | - Benoit Renaud
- Service of Pharmacology and Toxicology, Department of Functional Sciences, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Sart Tilman, 4000 Liège, Belgium
| | - Anne-Christine François
- Service of Pharmacology and Toxicology, Department of Functional Sciences, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Sart Tilman, 4000 Liège, Belgium
| | | | | | - François Boemer
- Biochemical Genetics Lab, Department of Human Genetics, CHU of Liege, University of Liege, 4000 Liège, Belgium
| | - Pascal De Tullio
- Center of Interdisciplinary Research on Medicines, Metabolomics group, University of Liège, 4000 Liège, Belgium
| | - Eric A Richard
- LABÉO (Frank Duncombe), 1 route de Rosel, 14053 Caen Cedex 4, France.,Normandie Université, UniCaen, EA7450 Biotargen, 3 rue Nelson Mandela, 14280 Saint-Contest, France
| | - Dominique-Marie Votion
- Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
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Wimmer-Scherr C, Taminiau B, Renaud B, van Loon G, Palmers K, Votion D, Amory H, Daube G, Cesarini C. Comparison of Fecal Microbiota of Horses Suffering from Atypical Myopathy and Healthy Co-Grazers. Animals (Basel) 2021; 11:ani11020506. [PMID: 33672034 PMCID: PMC7919468 DOI: 10.3390/ani11020506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/21/2022] Open
Abstract
Equine atypical myopathy (AM) is caused by hypoglycin A (HGA) and methylenecyclopropylglycine (MCPG) intoxication resulting from the ingestion of seeds or seedlings of some Acer tree species. Interestingly, not all horses pasturing in the same toxic environment develop signs of the disease. In other species, it has been shown that the intestinal microbiota has an impact on digestion, metabolism, immune stimulation and protection from disease. The objective of this study was to characterize and compare fecal microbiota of horses suffering from AM and healthy co-grazers. Furthermore, potential differences in fecal microbiota regarding the outcome of diseased animals were assessed. This prospective observational study included 59 horses with AM (29 survivors and 30 non-survivors) referred to three Belgian equine hospitals and 26 clinically healthy co-grazers simultaneously sharing contaminated pastures during spring and autumn outbreak periods. Fresh fecal samples (rectal or within 30 min of defecation) were obtained from all horses and bacterial taxonomy profiling obtained by 16S amplicon sequencing was used to identify differentially distributed bacterial taxa between AM-affected horses and healthy co-grazers. Fecal microbial diversity and evenness were significantly (p < 0.001) higher in AM-affected horses as compared with their non-affected co-grazers. The relative abundance of families Ruminococcaceae, Christensenellaceae and Akkermansiaceae were higher (p ≤ 0.001) whereas those of the Lachnospiraceae (p = 0.0053), Bacteroidales (p < 0.0001) and Clostridiales (p = 0.0402) were lower in horses with AM, especially in those with a poor prognosis. While significant shifts were observed, it is still unclear whether they result from the disease or might be involved in the onset of disease pathogenesis.
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Affiliation(s)
- Christina Wimmer-Scherr
- Equine Clinical Department, Faculty of Veterinary Medicine, Bât. B41, Sart Tilman, University of Liège, 4000 Liège, Belgium; (C.W.-S.); (H.A.)
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
| | - Bernard Taminiau
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
- Department of Food Sciences–Microbiology, Faculty of Veterinary Medicine, University of Liège, Avenue de Cureghem 10, Bât. B43b, 4000 Liège, Belgium
| | - Benoît Renaud
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
- Department of Functional Sciences, Pharmacology and Toxicology, Faculty of Veterinary Medicine, Bât. B41, Sart Tilman, University of Liège, 4000 Liège, Belgium
| | - Gunther van Loon
- Large Animal Internal Medicine, Gent University, 9820 Gent, Belgium;
| | | | - Dominique Votion
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
| | - Hélène Amory
- Equine Clinical Department, Faculty of Veterinary Medicine, Bât. B41, Sart Tilman, University of Liège, 4000 Liège, Belgium; (C.W.-S.); (H.A.)
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
| | - Georges Daube
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
- Department of Food Sciences–Microbiology, Faculty of Veterinary Medicine, University of Liège, Avenue de Cureghem 10, Bât. B43b, 4000 Liège, Belgium
| | - Carla Cesarini
- Equine Clinical Department, Faculty of Veterinary Medicine, Bât. B41, Sart Tilman, University of Liège, 4000 Liège, Belgium; (C.W.-S.); (H.A.)
- Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, Sart Tilman, University of Liège, 4000 Liège, Belgium; (B.T.); (B.R.); (D.V.); (G.D.)
- Correspondence:
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Votion DM, François AC, Kruse C, Renaud B, Farinelle A, Bouquieaux MC, Marcillaud-Pitel C, Gustin P. Answers to the Frequently Asked Questions Regarding Horse Feeding and Management Practices to Reduce the Risk of Atypical Myopathy. Animals (Basel) 2020; 10:ani10020365. [PMID: 32102384 PMCID: PMC7071031 DOI: 10.3390/ani10020365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/12/2020] [Accepted: 02/14/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Equine atypical myopathy is a severe intoxication of grazing equids resulting from the ingestion of samaras or seedlings of trees from the Acer species. The sycamore maple (Acer pseudoplatanus) is involved in European cases whereas the box elder (Acer negundo) is recognized as the cause of this seasonal pasture myopathy in the Unites States of America. In Europe, young and inactive animals with a thin to normal body condition and no feed supplementation, except for hay in autumn, are at higher risk. The risk is also associated with full time pasturing in a humid environment. Indeed, dead leaves piling up in autumn as well as, the presence of trees and/or woods presumably exposes the horses to the sycamore maple. This manuscript answers the most frequently asked questions arising from the equine field about feeding and management of equines to reduce the risk of atypical myopathy. All answers are based on data collected from 2006 to 2019 by the “Atypical Myopathy Alert Group” (AMAG, Belgium) and the “Réseau d’épidémiosurveillance en Pathologie équine” (RESPE, France) as well as on a review of the most recent literature. Abstract In 2014, atypical myopathy (AM) was linked to Acer pseudoplatanus (sycamore maple) in Europe. The emergence of this seasonal intoxication caused by a native tree has raised many questions. This manuscript aims at answering the five most frequently asked questions (FAQs) regarding (1) identification of toxic trees; reduction of risk at the level of (2) pastures and (3) equids; (4) the risk associated with pastures with sycamores that have always been used without horses being poisoned and (5) the length of the risk periods. Answers were found in a literature review and data gathered by AM surveillance networks. A guide is offered to differentiate common maple trees (FAQ1). In order to reduce the risk of AM at pasture level: Avoid humid pastures; permanent pasturing; spreading of manure for pasture with sycamores in the vicinity and avoid sycamore maple trees around pasture (FAQ2). To reduce the risk of AM at horse level: Reduce pasturing time according to weather conditions and to less than six hours a day during risk periods for horses on risk pasture; provide supplementary feeds including toxin-free forage; water from the distribution network; vitamins and a salt block (FAQ3). All pastures with a sycamore tree in the vicinity are at risk (FAQ4). Ninety-four percent of cases occur over two 3-month periods, starting in October and in March, for cases resulting from seeds and seedlings ingestion, respectively (FAQ5).
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Affiliation(s)
- Dominique-Marie Votion
- Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Lieège, 4000 Liège 1 (Sart Tilman), Belgium; (D.-M.V.); (M.-C.B.)
| | - Anne-Christine François
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
- Correspondence:
| | - Caroline Kruse
- Department of Functional Sciences, Faculty of Veterinary Medicine, Physiology and Sport Medicine, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium;
| | - Benoit Renaud
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
| | | | - Marie-Catherine Bouquieaux
- Equine Pole, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Lieège, 4000 Liège 1 (Sart Tilman), Belgium; (D.-M.V.); (M.-C.B.)
| | | | - Pascal Gustin
- Department of Functional Sciences, Faculty of Veterinary Medicine, Pharmacology and Toxicology, Fundamental and Applied Research for Animals & Health (FARAH), University of Liège, 4000 Liège 1 (Sart Tilman), Belgium; (B.R.); (P.G.)
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Dunkel B, Ryan A, Haggett E, Knowles EJ. Atypical myopathy in the South‐East of England: Clinicopathological data and outcome in hospitalised horses. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B. Dunkel
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - A. Ryan
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - E. Haggett
- Rossdales Equine Hospital and Diagnostic Centre Newmarket Suffolk UK
| | - E. J. Knowles
- Bell Equine Veterinary Clinic Mereworth Maidstone Kent UK
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González-Medina S, Ireland JL, Piercy RJ, Newton JR, Votion DM. Equine atypical myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival. Equine Vet J 2017; 49:746-752. [PMID: 28445006 DOI: 10.1111/evj.12694] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 04/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Equine atypical myopathy (AM) is a toxic rhabdomyolysis associated with ingestion of hypoglycin A, derived typically in Europe, from Acer pseudoplatanus tree. Despite the wide distribution of this tree species in the UK, the number of cases reported annually varies, and there has been an apparent increase in prevalence in recent years. Although AM was first recognised in the UK, epidemiological studies have never been conducted focused solely on this country. OBJECTIVES To describe the spatiotemporal distribution, presentation, treatment and outcome of AM cases reported in the UK. STUDY DESIGN Retrospective case series. METHODS British AM cases reported to the atypical myopathy alert website, between 2011 and 2015 were included (n = 224). Data were obtained via standardised epidemiological questionnaires from owners and veterinarians. Factors associated with survival were assessed using logistic regression. RESULTS Most cases reported were from England (87.9%). Survival was 38.6% (n = 73/189). Clinical factors associated with reduced odds of survival included, hypothermia (odds ratio [OR] 0.18; 95% confidence interval [CI] 0.06-0.57; P = 0.01), bladder distension (OR 0.11; CI 0.02-0.59; P = 0.01), tachycardia (OR 0.97; CI 0.94-0.99; P = 0.04) and serum creatine kinase activity >100,000 IU/L (OR 0.17; CI 0.04-0.68; P = 0.01) in the univariable analysis as well as recumbency. The latter was the only sign retained in multivariable analysis (OR = 0.19; CI 0.06-0.62; P = 0.006). Administration of vitamins during the disease was associated with survival (OR 3.75; CI 1.21-11.57; P = 0.02). MAIN LIMITATIONS Reporting cases to the Atypical Myopathy Alert Group is voluntary; therefore, under-reporting will result in underestimation of AM cases; furthermore, direct owner-reporting could have introduced misdiagnosis bias. CONCLUSION Some areas of the UK reported AM cases more commonly. Clinical signs such as recumbency, rectal temperature, distended bladder and serum creatine kinase activity might be useful prognostic indicators though should be considered in the context of the clinical picture. Treatment with vitamins increases odds of survival.
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Affiliation(s)
- S González-Medina
- Comparative Neuromuscular Diseases Laboratory, The Royal Veterinary College, London, UK.,Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - J L Ireland
- Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - R J Piercy
- Comparative Neuromuscular Diseases Laboratory, The Royal Veterinary College, London, UK
| | - J R Newton
- Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - D M Votion
- Equine Medicine Department, Pole Equine, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Fabius LS, Westermann CM. Evidence-based therapy for atypical myopathy in horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- L. S. Fabius
- Faculty of Veterinary Medicine; Utrecht University; Yalelaan Utrecht The Netherlands
| | - C. M. Westermann
- Faculty of Veterinary Medicine; Utrecht University; Yalelaan Utrecht The Netherlands
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Lemieux H, Boemer F, van Galen G, Serteyn D, Amory H, Baise E, Cassart D, van Loon G, Marcillaud-Pitel C, Votion DM. Mitochondrial function is altered in horse atypical myopathy. Mitochondrion 2016; 30:35-41. [PMID: 27374763 DOI: 10.1016/j.mito.2016.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/30/2016] [Accepted: 06/28/2016] [Indexed: 12/31/2022]
Abstract
Equine atypical myopathy in Europe is a fatal rhabdomyolysis syndrome that results from the ingestion of hypoglycin A contained in seeds and seedlings of Acer pseudoplatanus (sycamore maple). Acylcarnitine concentrations in serum and muscle OXPHOS capacity were determined in 15 atypical myopathy cases. All but one acylcarnitine were out of reference range and mitochondrial respiratory capacity was severely decreased up to 49% as compared to 10 healthy controls. The hallmark of atypical myopathy thus consists of a severe alteration in the energy metabolism including a severe impairment in muscle mitochondrial respiration that could contribute to its high death rate.
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Affiliation(s)
- Hélène Lemieux
- Faculty Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetics, CHU Liege, University of Liege, Belgium
| | - Gaby van Galen
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Didier Serteyn
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium; Centre of Oxygen, Research and Development, University of Liege, Liege, Belgium
| | - Hélène Amory
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Etienne Baise
- (e)Department of Animal Productions: Biostatistics, Economy and Animal Selection, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Dominique Cassart
- Department of Pathology, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | | | | | - Dominique-M Votion
- (i)Equine Pole, Fundamental and Applied Research for Animals and Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium.
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Bochnia M, Scheidemann W, Ziegler J, Sander J, Vollstedt S, Glatter M, Janzen N, Terhardt M, Zeyner A. Predictive value of hypoglycin A and methylencyclopropylacetic acid conjugates in a horse with atypical myopathy in comparison to its cograzing partners. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Bochnia
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
| | | | - J. Ziegler
- Department of Molecular Signal Processing; Leibniz Institute of Plant Biochemistry; Halle (Saale) Germany
| | - J. Sander
- Screening Labor Hanover; Ronnenberg Germany
| | - S. Vollstedt
- Traditional Chinese Equine Medicine; Bokholt-Hanredder Germany
| | - M. Glatter
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
| | - N. Janzen
- Screening Labor Hanover; Ronnenberg Germany
- Department of Clinical Chemistry; Hanover Medical School; Hanover Germany
| | | | - A. Zeyner
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
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Westermann CM, van Leeuwen R, van Raamsdonk LWD, Mol HGJ. Hypoglycin A Concentrations in Maple Tree Species in the Netherlands and the Occurrence of Atypical Myopathy in Horses. J Vet Intern Med 2016; 30:880-4. [PMID: 26995161 PMCID: PMC4913566 DOI: 10.1111/jvim.13927] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/15/2016] [Accepted: 02/18/2016] [Indexed: 11/28/2022] Open
Abstract
Background Atypical myopathy (AM) in horses is caused by the plant toxin hypoglycin A, which in Europe typically is found in the sycamore maple tree (Acer pseudoplatanus). Owners are concerned about whether their horses are in danger if they graze near maple trees. Hypothesis/Objectives To measure hypoglycin A in the most common maple tree species in the Netherlands, and to determine whether concentration of toxin is a predictor of AM in horses. Methods A total of 278 samples of maple tree leaves, sprouts, and seeds were classified by species. Mean concentrations of hypoglycin A were compared for the type of sample, the season and the occurrence of AM in the pasture (non‐AM versus AM). Statistical analysis was performed using generalized a linear model (SPPS22). Results Almost all Acer pseudoplatanus samples contained hypoglycin A, with concentrations differing significantly among sources (P < .001). Concentrations were significantly higher in seeds from the AM group than in seeds from the non‐AM group (856 ± 677 and 456 ± 358 mg/kg, respectively; P = .039). In sprouts and leaves this was not the case. Acer platanoides and Acer campestre samples did not contain detectable concentrations of hypoglycin A. Conclusions and clinical importance Acer platanoides and campestre seem to be safe around paddocks and pastures, whereas almost all Acer pseudoplatanus samples contained hypoglycin A. In all AM cases, Acer pseudoplatanus was found. Despite significantly higher concentration of hypoglycin A in seeds of pastures where AM has occurred, individual prediction of AM cannot be made by measuring these concentrations because of the high standard deviation.
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Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | | | | | - H G J Mol
- RIKILT-Wageningen UR, Wageningen, the Netherlands
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Votion DM, van Galen G, Sweetman L, Boemer F, de Tullio P, Dopagne C, Lefère L, Mouithys-Mickalad A, Patarin F, Rouxhet S, van Loon G, Serteyn D, Sponseller BT, Valberg SJ. Identification of methylenecyclopropyl acetic acid in serum of European horses with atypical myopathy. Equine Vet J 2013; 46:146-9. [PMID: 23773055 DOI: 10.1111/evj.12117] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/09/2013] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY It is hypothesised that European atypical myopathy (AM) has a similar basis as seasonal pasture myopathy in North America, which is now known to be caused by ingestion of hypoglycin A contained in seeds from the tree Acer negundo. Serum from horses with seasonal pasture myopathy contained the conjugated toxic metabolite of hypoglycin A, methylenecyclopropyl acetic acid (MCPA). STUDY DESIGN Retrospective study on archived samples. OBJECTIVES 1) To determine whether MCPA-carnitine was present in serum of European horses confirmed to have AM; 2) to determine whether Acer negundo or related Acer species were present on AM pastures in Europe. METHODS Concentrations of MCPA-carnitine were analysed in banked serum samples of 17 AM horses from Europe and 3 diseased controls (tetanus, neoplasia and exertional rhabdomyolysis) using tandem mass spectrometry. Atypical myopathy was diagnosed by characteristic serum acylcarnitine profiles. Pastures of 12 AM farms were visited by experienced botanists and plant species were documented. RESULTS Methylenecyclopropyl acetic acid-carnitine at high concentrations (20.39 ± 17.24 nmol/l; range 0.95-57.63 nmol/l; reference: <0.01 nmol/l) was identified in serum of AM but not disease controls (0.00 ± 0.00 nmol/l). Acer pseudoplatanus but not Acer negundo was present on all AM farms. CONCLUSIONS Atypical myopathy in Europe, like seasonal pasture myopathy in North America, is highly associated with the toxic metabolite of hypoglycin A, MCPA-carnitine. This finding coupled with the presence of a tree of which seeds are known to also contain hypoglycin A indicates that ingestion of Acer pseudoplatanus is the probable cause of AM. This finding has major implications for the prevention of AM.
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Affiliation(s)
- D-M Votion
- Equine Clinic, Faculty of Veterinary Medicine, University of Liege, Belgium
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Contribution to the Understanding of Unexplained Death of Pasturing Horses in the North of Spain: A Retrospective Case Series. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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14
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van Galen G, Cerri S, Porter S, Saegerman C, Lefere L, Roscher K, Marr C, Amory H, Votion DM. Traditional and quantitative assessment of acid-base and shock variables in horses with atypical myopathy. J Vet Intern Med 2012. [PMID: 23193982 DOI: 10.1111/jvim.12003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Descriptions of acid-base disturbances in atypical myopathy (AM) are limited. OBJECTIVES Describe and compare traditional and quantitative acid-base abnormalities and cardiovascular shock status in horses with AM at admission. ANIMALS 34 horses with AM, 15 healthy controls. METHODS Retrospective case-control study. Records were searched for shock variables (packed cell volume [PCV], blood urea nitrogen [BUN], heart and respiratory rate) and acid-base variables (venous blood gas analysis, electrolytes, total protein, lactate) on admission. Base excess (BE) of free water (BEfw), chloride (BEcl), total protein (BEtp), and unidentified anions (BEua), anion gap (AG), measured strong ion difference (SIDm), and concentration of total nonvolatile weak acids ([Atot]) were calculated. Acid-base classifications, using simplified strong ion model and traditional approach, and shock grades were assigned. A 2-sample Wilcoxon rank-sum test and Bonferroni correction compared variables in AM cases versus control horses. Significance was P < .05/16 for acid-base and P < .05/5 for shock variables. RESULTS Tachycardia, tachypnea, and normal to increased PCV and BUN were common in AM cases. Respiratory, metabolic acid-base alterations, or both were mainly caused by respiratory alkalosis, lactic acidosis, and SIDm alkalosis, alone or in combination. Evaluated variables (except pH, potassium concentration, total protein, and related calculations) were significantly different (P < .001) between AM cases and control horses. The strong ion model provided a more accurate assessment than the traditional approach and identified mixed derangements. CONCLUSIONS AND CLINICAL IMPORTANCE Acid-base derangements should be evaluated in horses with AM and this preferably with the strong ion model.
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Affiliation(s)
- G van Galen
- Department of Epidemiology, Unité de recherche en epidémiologie et analyse de risques appliquées aux sciences vétérinaires, FMV University of Liege, Belgium.
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Votion DM. The story of equine atypical myopathy: a review from the beginning to a possible end. ISRN VETERINARY SCIENCE 2012; 2012:281018. [PMID: 23762581 PMCID: PMC3671727 DOI: 10.5402/2012/281018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 09/25/2012] [Indexed: 11/23/2022]
Abstract
Atypical myopathy (AM) is a frequently fatal seasonal pasture myopathy that emerges in Europe. Outbreaks are of an acute and unexpected nature and practitioners should be prepared to handle these critically ill patients. This review retraces the history of AM and describes results of epidemiological investigations that were conducted to raise hypotheses concerning the etiology of this devastating disease as well as to be able to suggest potential preventive measures. Also, clinical studies have contributed to a better definition and recognition of the syndrome, whereas elucidation of the pathological process, identified as a multiple acyl-CoA dehydrogenase deficiency (MADD), was a great step forward improving medical management of AM and guiding the search for the etiological agent towards toxins that reproduce the identified defect. Treatment plans can be extrapolated from the described clinical signs and metabolic problems, but they remain limited to supportive care until the causative agent has been identified with certainty. Since treatment is still unsuccessful in the majority of cases, the main emphasis is currently still on prevention. This paper aims at being a practical support for equine clinicians dealing with AM and is based on discussion and comparison of the currently available scientific data.
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Affiliation(s)
- Dominique-Marie Votion
- Equine Clinic, Faculty of Veterinary Medicine, University of Liege, Boulevard de Colonster 20 B41, 4000 Liege, Belgium
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van Galen G, Votion DM. Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 2: Muscular, urinary, respiratory and hepatic care, and inflammatory/infectious status. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00441.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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van Galen G, Votion DM. Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: First aid, cardiovascular, nutritional and digestive care. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00439.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sponseller BT, Valberg SJ, Schultz NE, Bedford H, Wong DM, Kersh K, Shelton GD. Equine multiple acyl-CoA dehydrogenase deficiency (MADD) associated with seasonal pasture myopathy in the midwestern United States. J Vet Intern Med 2012; 26:1012-8. [PMID: 22708588 DOI: 10.1111/j.1939-1676.2012.00957.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/16/2012] [Accepted: 05/09/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Seasonal pasture myopathy (SPM) is a highly fatal form of nonexertional rhabdomyolysis that occurs in pastured horses in the United States during autumn or spring. In Europe, a similar condition, atypical myopathy (AM), is common. Recently, a defect of lipid metabolism, multiple acyl-CoA dehydrogenase deficiency (MADD), has been identified in horses with AM. OBJECTIVE To determine if SPM in the United States is caused by MADD. ANIMALS Six horses diagnosed with SPM based on history, clinical signs, and serum creatine kinase activity, or postmortem findings. METHODS Retrospective descriptive study. Submissions to the Neuromuscular Diagnostic Laboratory at the University of Minnesota were reviewed between April 2009 and January 2010 to identify cases of SPM. Inclusion criteria were pastured, presenting with acute nonexertional rhabdomyolysis, and serum, urine, or muscle samples available for analysis. Horses were evaluated for MADD by urine organic acids, serum acylcarnitines, muscle carnitine, or histopathology. RESULTS Six horses had clinical signs and, where performed (4/6 horses), postmortem findings consistent with SPM. Affected muscle (4/4) showed degeneration with intramyofiber lipid accumulation, decreased free carnitine concentration, and increased carnitine esters. Serum acylcarnitine profiles (3/3) showed increases in short- and medium-chain acylcarnitines and urinary organic acid profiles (3/3) revealed increased ethylmalonic and methylsuccinic acid levels, and glycine conjugates, consistent with equine MADD. CONCLUSIONS AND CLINICAL IMPORTANCE Similar to AM, the biochemical defect causing SPM is MADD, which causes defective muscular lipid metabolism and excessive myofiber lipid content. Diagnosis can be made by assessing serum acylcarnitine and urine organic acid profiles.
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Affiliation(s)
- B T Sponseller
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA.
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van Galen G, Marcillaud Pitel C, Saegerman C, Patarin F, Amory H, Baily JD, Cassart D, Gerber V, Hahn C, Harris P, Keen JA, Kirschvink N, Lefere L, McGorum B, Muller JMV, Picavet MTJE, Piercy RJ, Roscher K, Serteyn D, Unger L, van der Kolk JH, van Loon G, Verwilghen D, Westermann CM, Votion DM. European outbreaks of atypical myopathy in grazing equids (2006-2009): spatiotemporal distribution, history and clinical features. Equine Vet J 2012; 44:614-20. [PMID: 22448904 DOI: 10.1111/j.2042-3306.2012.00556.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY Improved understanding of the epidemiology of atypical myopathy (AM) will help to define the environmental factors that permit or support the causal agent(s) to exert toxicity. OBJECTIVES This European survey of AM aimed to describe spatiotemporal distribution, survival, clinical signs, circumstances in which AM develops and its different expressions between countries and over time. METHODS The spatiotemporal distribution, history and clinical features of AM cases reported to the Atypical Myopathy Alert Group from 2006 to 2009 were described. Comparisons of data from the most severely affected countries and from the large outbreaks were made with Fisher's exact and Welch's tests with Bonferroni correction. RESULTS Of 600 suspected cases, 354 met the diagnostic criteria for confirmed or highly probable AM. The largest outbreaks occurred during the autumns of 2006 and 2009 in Belgium, France and Germany. For the first time, donkeys, zebras and old horses were affected, and clinical signs such as gastrointestinal impaction, diarrhoea, penile prolapse, buccal ulceration and renal dysfunction were observed. Affected horses spent >6 h/day on pastures that almost always contained or were surrounded by trees. The latency period was estimated at up to 4 days. Overall survival rate was 26%. Although differences between countries in affected breeds, body condition, horse management and pasture characteristics were recognised, the common presenting clinical signs and mortality were similar between countries. CONCLUSIONS AND POTENTIAL RELEVANCE This study describes new data on case details, history and clinical course of AM that is of preventive, diagnostic and therapeutic value. However, the true impact of the findings of this study on the development of or severity of AM should be tested with case-control studies.
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Affiliation(s)
- G van Galen
- Department of Epidemiology, Faculty of Veterinary Medicine, University of Liege, Belgium.
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20
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van Galen G, Saegerman C, Marcillaud Pitel C, Patarin F, Amory H, Baily JD, Cassart D, Gerber V, Hahn C, Harris P, Keen JA, Kirschvink N, Lefere L, McGorum B, Muller JMV, Picavet MTJE, Piercy RJ, Roscher K, Serteyn D, Unger L, van der Kolk JH, van Loon G, Verwilghen D, Westermann CM, Votion DM. European outbreaks of atypical myopathy in grazing horses (2006-2009): determination of indicators for risk and prognostic factors. Equine Vet J 2012; 44:621-5. [PMID: 22413891 DOI: 10.1111/j.2042-3306.2012.00555.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY Appropriate management of atypical myopathy (AM) requires the establishment of an accurate diagnosis and prognosis. Furthermore, preventive measures to avoid AM need to be refined. OBJECTIVES The aims of the study were as follows: 1) to improve the diagnosis of AM; 2) to identify prognostic predictors; and 3) to refine recommended preventive measures based on indicators of risk factors. METHODS An exploratory analysis of cases in Europe between 2006 and 2009 reported to the Atypical Myopathy Alert Group was conducted. Based on clinical data, reported cases were allocated into 2 groups: confirmed or highly probable AM (AM group; further divided into survivors and nonsurvivors); and cases with a low probability of having AM or with another final diagnosis (non-AM group). Using Welch's test and odds ratios corrected for multiple comparisons, the AM vs. non-AM groups were compared to identify indicators for diagnosis and risk factors, and survivors vs. nonsurvivors in the AM group were compared to identify prognostic factors. Sensitivity, specificity and positive and negative predictive values were calculated for specific clinical signs related to final diagnosis and outcome. RESULTS From 600 reported cases, 354 AM cases (survival rate of 26%) and 69 non-AM cases were identified, while there were insufficient data to categorise the remainder. Variables valuable for diagnosing AM compared with similar diseases were as follows: presence of dead leaves and wood and/or trees on pastures; sloping pastures; full-time pasture access; no food supplementation; normal body condition; pigmenturia; normothermia; and congested mucous membranes. Nonsurvival was associated with recumbency, sweating, anorexia, dyspnoea, tachypnoea and/or tachycardia. Survival was associated with remaining standing most of the time, normothermia, normal mucous membranes, defaecation and vitamin and antioxidant therapy. CONCLUSIONS AND POTENTIAL RELEVANCE This study refines the list of risk factors for AM. Clinical signs valuable for diagnosis and prognosis have been identified, enabling clinicians to improve management of AM cases.
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Affiliation(s)
- G van Galen
- Department of Epidemiology, Faculty of Veterinary Medicine, University of Liege, Belgium.
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Westermann CM, Dorland L, van Diggelen OP, Schoonderwoerd K, Bierau J, Waterham HR, van der Kolk JH. Decreased oxidative phosphorylation and PGAM deficiency in horses suffering from atypical myopathy associated with acquired MADD. Mol Genet Metab 2011; 104:273-8. [PMID: 21843962 DOI: 10.1016/j.ymgme.2011.07.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 07/21/2011] [Indexed: 11/27/2022]
Abstract
Earlier research on ten horses suffering from the frequently fatal disorder atypical myopathy showed that MADD (multiple acyl-CoA dehydrogenase deficiency) is the biochemical derangement behind atypical myopathy. From five horses that died as a result of this disease and seven healthy control horses, urine and plasma were collected ante mortem and muscle biopsies were obtained immediately post-mortem (2 patients and 7 control horses), to analyse creatine, purine and carbohydrate metabolism as well as oxidative phosphorylation. In patients, the mean creatine concentration in urine was increased 17-fold and the concentration of uric acid approximately 4-fold, compared to controls. The highest degree of depletion of glycogen was observed in the patient with the most severe myopathy clinically. In this patient, glycolysis was more active than in the other patients and controls, which may explain this depletion. One patient demonstrated very low phosphoglycerate mutase (PGAM) activity, less than 10% of reference values. Most respiratory chain complex activity in patients was 20-30% lower than in control horses, complex II activity was 42% lower than normal, and one patient had severely decrease ATP-synthase activity, more than 60% lower than in control horses. General markers for myopathic damage are creatine kinase (CK) and lactic acid in plasma, and creatine and uric acid in urine. To obtain more information about the cause of the myopathy analysis of carbohydrate, lipid and protein metabolism as well as oxidative phosphorylation is advised. This study expands the diagnostic possibilities of equine myopathies.
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Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Medicine Section, Faculty of Veterinary Medicine, Yalelaan 114, 3584 CM, Utrecht University, Utrecht, The Netherlands.
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Van Galen G, Amory H, Busschers E, Cassart D, De Bruijn M, Gerber V, Keen J, Lefere L, Pitel CM, Marr C, Müller JMV, Pineau X, Saegerman C, Sandersen C, Serteyn D, Torfs S, Unger L, Verwilghen D, Votion DM. European outbreak of atypical myopathy in the autumn 2009. J Vet Emerg Crit Care (San Antonio) 2010; 20:528-32. [PMID: 20955305 DOI: 10.1111/j.1476-4431.2010.00574.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atypical myopathy is an acute, severe rhabdomyolysis occurring in grazing horses. In the beginning of October 2009, a new outbreak occurred in several European countries. Geographic, demographic and clinical data of the reported cases in the month October 2009 are described. KEY FINDINGS The survival rate in this outbreak was 25%. The most frequently observed clinical signs were congested mucous membranes, dyspnea, tachycardia, depression, weakness, stiffness, recumbency, trembling, sweating, and myoglobinuria. Nonsurvivors were significantly more likely to be recumbent than survivors. Prognostic factors, symptomatic treatment, and preventive measures are discussed. SIGNIFICANCE Differences were encountered during the described outbreak of atypical myopathy in October 2009 compared with previous outbreaks reported. Equine practitioners should be aware that previous epidemiological studies have shown that after a high prevalence in the autumn, new cases are likely to occur in the following spring.
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Affiliation(s)
- Gaby Van Galen
- Equine Teaching Hospital, Faculty of Veterinary Medicine, Liege University, Liege, Belgium.
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El-Deeb WM, El-Bahr SM. Investigation of selected biochemical indicators of Equine Rhabdomyolysis in Arabian horses: pro-inflammatory cytokines and oxidative stress markers. Vet Res Commun 2010; 34:677-89. [PMID: 20830520 DOI: 10.1007/s11259-010-9439-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2010] [Indexed: 01/08/2023]
Abstract
A total of 30 horses were divided into two groups, one served as a control whereas other was rhabdomyolysis diseased horses. After blood collection, the resulted sera were used for estimation of the activities of creatin kinase (CK), aspartate transaminase (AST), lactate dehydrogenase (LDH), lactic acid, triacylglycerol (TAG), glucose, total protein, albumin, globulin, urea, creatinine, Triiodothyronine (T(3)), calcium, sodium, potassium, phosphorus, chloride, vitamin E, interleukin-6 (IL-6) and tumor necrosis-α (TNF-α). In addition, whole blood was used for determination of selenium, reduced glutathione (G-SH) and prostaglandin F2-α (PGF2α). The erythrocyte hemolysates were used for the determination of the activities of super oxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAC), nitric oxide (NO) and malondialdehyde (MDA). The present findings revealed a significant (p ≤ 0.05) increase in the values of CK, AST, LDH, glucose, lactate, TAG, urea, creatinine, phosphorus, MDA, TNF- α, IL6 and PGF2- α in diseased horses when compared with the control. Furthermore, the values of calcium, SOD, CAT, TAC, NO and GSH in diseased horses were significantly (p ≤ 0.05) lower than the control. The other examined parameters were not statistically significant. In conclusion, the examined pro-inflammatory cytokines were useful biomarkers for the diagnosis of Equine rhabdomyolysis (ER) in Arabian horses beside the old examined biomarkers. In the future, efforts should be made to confirm this in other breed. If this could be achieved, it would open up new perspectives in research fields dealing with ER.
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Affiliation(s)
- Wael Mohamed El-Deeb
- Department of clinical studies, College of Veterinary Medicine and animal Resources, King Faisal University, P.O. Box: 1757, Al-Ahsa, 31982, Saudi Arabia.
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Cassart D, Baise E, Cherel Y, Delguste C, Antoine N, Votion D, Amory H, Rollin F, Linden A, Coignoul F, Desmecht D. Morphological alterations in oxidative muscles and mitochondrial structure associated with equine atypical myopathy. Equine Vet J 2010; 39:26-32. [PMID: 17228591 DOI: 10.2746/042516407x157765] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY There is a lack of well documented studies about muscular lesions in equine atypical myopathy (EAM). OBJECTIVES To characterise morphopathological changes of striated muscles and myocardium, to progress understanding of this disease. METHODS Thirty-two horses age 0.5-7 years kept on pasture were referred for a sudden ataxia/myoglobinuria syndrome. Clinical examination (stiffness, muscle pain, muscle fasciculations, abnormal gait, recumbency, myoglobinuria, tachycardia, sweating) and plasma CPK, LDH and AST levels were consistent with extensive myonecrosis and, together with anamnestic data, with so-called 'equine atypical myopathy' (EAM), a disease of unknown aetiology reported since 1939. Macroscopic and microscopic (histology, histoenzymology, ultrastructure) lesions were evaluated. RESULTS Necropsic examination revealed large areas of muscle necrosis, the extent and severity of which varied between cases and muscles, but which were clearly more constant and severe in respiratory and postural muscles and in the myocardium. Histology highlighted a multifocal and monophasic process compatible with Zenker degeneration/necrosis that mostly and segmentally affected type 1 fibres. Histochemical evaluation revealed a weak and disorganised pattern of NADH tetrazolium reductase staining, the absence of calcium salts precipitates and a dramatic accumulation of lipid droplets. Ultrastructural examination often revealed fibres of which the sole modifications were altered mitochondria and sarcoplasmic lipidosis. CONCLUSIONS Taken together, the data suggest that a primary alteration of mitochondria should be considered, although secondary mitochondrial abnormalities have yet to be ruled out. POTENTIAL RELEVANCE The morphological features gathered here reveal that EAM shares most of the characteristics of toxic myopathies.
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Affiliation(s)
- D Cassart
- Department of Pathology, Faculty of Veterinary Medicine, University of Liège, Sart Tilman B43, B-4000 Liège, Belgium
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Vercauteren G, van der Heyden S, Lefère L, Chiers K, Laevens H, Ducatelle R. Concurrent atypical myopathy and equine dysautonomia in two horses. Equine Vet J 2010; 39:463-5. [PMID: 17910273 DOI: 10.2746/042516407x206409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This report concerns 2 horses that suffered typical clinical signs of atypical myopathy (AM) and equine grass sickness (EGS) concurrently. Clinical details and pathological lesions of the cases are described. EGS and AM are relatively rare diseases and the concurrency of the diseases in the same animals is therefore considered unlikely to be a coincidence. However, it is not suggested that the evidence shows a common aetiology but rather the existence of common predisposing causes.
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Affiliation(s)
- G Vercauteren
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Westermann CM, Dorland L, Votion DM, de Sain-van der Velden MGM, Wijnberg ID, Wanders RJA, Spliet WGM, Testerink N, Berger R, Ruiter JPN, van der Kolk JH. Acquired multiple Acyl-CoA dehydrogenase deficiency in 10 horses with atypical myopathy. Neuromuscul Disord 2008; 18:355-64. [PMID: 18406615 DOI: 10.1016/j.nmd.2008.02.007] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 02/07/2008] [Accepted: 02/18/2008] [Indexed: 11/29/2022]
Abstract
The aim of the current study was to assess lipid metabolism in horses with atypical myopathy. Urine samples from 10 cases were subjected to analysis of organic acids, glycine conjugates, and acylcarnitines revealing increased mean excretion of lactic acid, ethylmalonic acid, 2-methylsuccinic acid, butyrylglycine, (iso)valerylglycine, hexanoylglycine, free carnitine, C2-, C3-, C4-, C5-, C6-, C8-, C8:1-, C10:1-, and C10:2-carnitine as compared with 15 control horses (12 healthy and three with acute myopathy due to other causes). Analysis of plasma revealed similar results for these predominantly short-chain acylcarnitines. Furthermore, measurement of dehydrogenase activities in lateral vastus muscle from one horse with atypical myopathy indeed showed deficiencies of short-chain acyl-CoA dehydrogenase (0.66 as compared with 2.27 and 2.48 in two controls), medium-chain acyl-CoA dehydrogenase (0.36 as compared with 4.31 and 4.82 in two controls) and isovaleryl-CoA dehydrogenase (0.74 as compared with 1.43 and 1.61 nmol min(-1) mg(-1) in two controls). A deficiency of several mitochondrial dehydrogenases that utilize flavin adenine dinucleotide as cofactor including the acyl-CoA dehydrogenases of fatty acid beta-oxidation, and enzymes that degrade the CoA-esters of glutaric acid, isovaleric acid, 2-methylbutyric acid, isobutyric acid, and sarcosine was suspected in 10 out of 10 cases as the possible etiology for a highly fatal and prevalent toxic equine muscle disease similar to the combined metabolic derangements seen in human multiple acyl-CoA dehydrogenase deficiency also known as glutaric acidemia type II.
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Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Medicine Section, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, 3508 TD Utrecht, The Netherlands
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Votion DM, Linden A, Delguste C, Amory H, Thiry E, Engels P, van Galen G, Navet R, Sluse F, Serteyn D, Saegerman C. Atypical myopathy in grazing horses: a first exploratory data analysis. Vet J 2008; 180:77-87. [PMID: 18396430 DOI: 10.1016/j.tvjl.2008.01.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 01/21/2008] [Accepted: 01/22/2008] [Indexed: 11/28/2022]
Abstract
Over the last decade, atypical myopathy (AM) in grazing horses has emerged in several European countries. An exploratory analysis was conducted to determine horse- and pasture-level indicators or factors associated with AM in Belgium. Belgian cases of AM confirmed by histology (n=57) were compared to their healthy co-grazing horses (n=77) and to pastured horses not involved with AM as controls (n=386). The pastures where confirmed cases were grazing (42 pastures; 38 sites; 44 incidences of AM) were compared with those of the controls (216 pastures; 96 sites; no incidence of AM). Statistically significant (P< or =0.05) exploratory variables, identified by means of adjusted odds ratios, suggested that indicators or factors associated with individual horses (young age, inactivity, body condition poor to normal), management practices (permanent pasturing, spreading of manure) and pasture characteristics (humid, sloping pastures, accumulated dead leaves, presence of waterway) may increase the risk of AM. Specific interventions based on these factors might help to reduce the incidence of AM.
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Affiliation(s)
- Dominique-M Votion
- Equine Teaching Hospital, Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium.
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Equine atypical myopathy: a review. Vet J 2008; 178:185-90. [PMID: 18375157 DOI: 10.1016/j.tvjl.2008.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 02/01/2008] [Accepted: 02/08/2008] [Indexed: 11/21/2022]
Abstract
Atypical myopathy (AM) is an acute rhabdomyolysis syndrome that occurs at irregular intervals in grazing equines. An increasing number of outbreaks have been reported in recent years, including some from countries where the disease has not previously been diagnosed. In this review, clinical and other details of outbreaks of AM are analysed to better define its epidemiological profile. Potential aetiologies are discussed, the short clinical course of AM is described and the main biochemical and pathological findings are considered. Recommendations for medical management are suggested, based on a review of clinical reports. Biochemical and histopathological findings have been integrated in order to characterise the physiopathology of AM. There is an ongoing requirement to record new cases of this syndrome, ideally through an epidemiological network.
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Votion DM, Linden A, Saegerman C, Engels P, Erpicum M, Thiry E, Delguste C, Rouxhet S, Demoulin V, Navet R, Sluse F, Serteyn D, Galen G, Amory H. History and Clinical Features of Atypical Myopathy in Horses in Belgium (2000-2005). J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb01962.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cassart D, Fett T, Sarlet M, Baise E, Coignoul F, Desmecht D. Flow cytometric probing of mitochondrial function in equine peripheral blood mononuclear cells. BMC Vet Res 2007; 3:25. [PMID: 17903245 PMCID: PMC2045081 DOI: 10.1186/1746-6148-3-25] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 09/28/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The morphopathological picture of a subset of equine myopathies is compatible with a primary mitochondrial disease, but functional confirmation in vivo is still pending. The cationic dye JC-1 exhibits potential-dependent accumulation in mitochondria that is detectable by a fluorescence shift from green to orange. As a consequence, mitochondrial membrane potential can be optically measured by the orange/green fluorescence intensity ratio. A flow cytometric standardized analytic procedure of the mitochondrial function of equine peripheral blood mononuclear cells is proposed along with a critical appraisal of the crucial questions of technical aspects, reproducibility, effect of time elapsed between blood sampling and laboratory processing and reference values. RESULTS The JC-1-associated fluorescence orange and green values and their ratio were proved to be stable over time, independent of age and sex and hypersensitive to intoxication with a mitochondrial potential dissipator. Unless time elapsed between blood sampling and laboratory processing does not exceed 5 hours, the values retrieved remain stable. Reference values for clinically normal horses are given. CONCLUSION Whenever a quantitative measurement of mitochondrial function in a horse is desired, blood samples should be taken in sodium citrate tubes and kept at room temperature for a maximum of 5 hours before the laboratory procedure detailed here is started. The hope is that this new test may help in confirming, studying and preventing equine myopathies that are currently imputed to mitochondrial dysfunction.
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Affiliation(s)
- Dominique Cassart
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
| | - Thomas Fett
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
| | - Michaël Sarlet
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
| | - Etienne Baise
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
| | - Freddy Coignoul
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
| | - Daniel Desmecht
- Department of Pathology, Faculty of Veterinary Medicine, University of Liege, Sart Tilman B43, B-4000 Liège, Belgium
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