Biochemical indices of vascular function, glucose metabolism and oxidative stress in horses with equine Cushing's disease

Thiobarbituric acid reactive substances in dogs with spontaneous hypercortisolism

Thiobarbituric acid reactive substances (TBARS) are laboratory markers of oxidative stress, which can be used to evaluate the lipid peroxidation that characterizes cell membrane damage caused by excess free radicals. This prospective study aimed to assess TBARS as a parameter of lipid peroxidation in dogs with spontaneous hypercortisolism (HC) at the time of diagnosis, and after trilostane treatment. Furthermore, it aimed to investigate the correlations between TBARS levels, and laboratory and cardiovascular parameters. Sixteen dogs with HC were evaluated at 3 different time points: At diagnosis (T0), 6 mo after treatment (T1), and 12 mo after trilostane treatment (T2). A control group (n = 20) of dogs with a demographic profile similar to the HC group, but considered healthy was selected and evaluated. There was a significant difference (P < 0.001) in TBARS levels between the HC group at diagnosis (4.38 ± 1.16 nmoles MDA/mg protein) and the control group (2.15 ± 0.45 nmoles MDA/mg protein). Dogs in the HC group exhibited a significant reduction (P < 0.001) in TBARS levels after treatment. There was no significant difference in TBARS levels between the control group and the HC group at T1 and T2 evaluation. TBARS positively correlated with left atrial dimensions and hematocrit. The study demonstrates that lipid peroxidation is increased in canine HC and suggests that control of the disease is beneficial to normalize the state of oxidative stress.

Effect of uterine ozone therapy and anticoagulant sampling on oxidative stress parameters in mares

With the purpose of assessing the effects of uterine ozone therapy and anticoagulant sampling on oxidative stress (OS) parameters in mares, ten mares underwent three consecutive days of uterine ozone therapy by flushing the uterus with ozonated lactated Ringer's solution followed by insufflation with ozone‑oxygen gas. Serum samples were obtained at baseline and days 3, 6, 10 and 17 to determine the effect of ozone therapy on OS markers. Plasma obtained with anticoagulants citrate, ethylenediaminetetraacetic acid (EDTA) and heparin were at baseline and 6 days following therapy to determine the effect of anticoagulant on OS parameters. Antioxidants albumin and uric acid, total antioxidant capacity (TAC) using four different methods, total oxidant capacity (TOC) and lipid peroxidation were determined through photocolorimetry. Statistical analyses comprised repeated measures ANOVA followed by Dunnett's test or Friedman followed by Dunn's post-hoc test. Differences were considered significant when p < 0.05. Uterine ozone therapy significantly decreased uric acid, TAC in all four different methods, concomitantly with an increase on TOC at days 3 and 6 following therapy. No changes were observed on albumin and lipid peroxidation levels. Anticoagulants prevented the detection of oxidative stress induced by uterine ozone therapy depending on the method of analysis. In conclusion, uterine ozone therapy causes systemic oxidative stress in mares and the choice of anticoagulant sampling interferes with laboratory tests.

Validation of a flow cytometric assay to detect intraerythrocytic reactive oxygen species in horses

BACKGROUND

Oxidative stress refers to the accumulation of reactive oxygen species (ROS). Most assays for ROS detection are costly, laborious, and usually use indirect markers. The use of 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) is a possible alternative. This substance becomes a fluorochrome when oxidized by ROS, with the resultant fluorescence proportional to ROS concentration. Erythrocytes are highly exposed to ROS, resulting in cell damage and consequently impaired oxygen delivery. The effects of this exposure in physiologic and pathologic conditions necessitate an improvement in ROS detection methods.

OBJECTIVE

We aimed to validate intraerythrocytic ROS detection by flow cytometry using DCHF-DA in healthy horses.

METHODS

Erythrocytes from 31 healthy horses were isolated, incubated with DCFH-DA, and either left unstimulated or stimulated with hydrogen peroxide (H₂ O₂ ). For specificity, each cellular component of blood was separated and plotted according to its size and complexity. Samples were run in triplicate for intra-assay precision and five consecutive times for inter-assay repeatability. Stability was determined by analyzing the same sample up to 48 hours after blood collection. The acceptable coefficient of variation (CV) was ≤20%.

RESULTS

The intra-assay CV was 1.7% and 13.3%, and the inter-assay CV was 4.8% and 17.8% for unstimulated and stimulated samples, respectively. Unstimulated and stimulated samples were stable for up to 48 and 24 hours, respectively. Stimulated samples had greater fluorescence than unstimulated samples (P < .0001).

CONCLUSIONS

This flow cytometric assay demonstrated adequate specificity, precision, and stability and is, therefore, a promising technique with multiple applications for studying oxidative stress in horses.

Clinical implications of using adrenocorticotropic hormone diagnostic cutoffs or reference intervals to diagnose pituitary pars intermedia dysfunction in mature horses

BACKGROUND

Diagnosis of pituitary pars intermedia dysfunction (PPID) is problematic because of large variations in ACTH concentrations.

HYPOTHESIS/OBJECTIVES

Compare the test characteristics of baseline and post-thyrotropin-releasing hormone (TRH) stimulation plasma ACTH concentrations in horses using diagnostic cutoff values (DCOVs) and reference intervals (RIs) and determine the clinical consequences of using each method.

ANIMALS

One hundred six mature horses: 72 control cases and 34 PPID cases.

METHODS

Prospective case-controlled study. Horses underwent monthly TRH stimulation tests. Diagnostic cutoff values were determined monthly by receiver operating characteristic curves using the Youden index. Reference intervals were determined monthly by a robust method. For each case age, sex and body condition score (BCS) were recorded.

RESULTS

Baseline ACTH concentrations varied by month (P < .001) with significant "month × age" (P = .003), "month × sex" (P = .003), and "month × BCS" (P = .007) effects. Baseline ACTH concentrations were accurate to diagnose PPID (0.91 ± 0.06) with DCOVs increasing the test sensitivity (0.61 ± 0.21 to 0.87 ± 0.05, P = .002) and RI increasing test specificity (0.85 ± 0.12 to 0.98 ± 0.01, P = .01). Thyrotropin-releasing hormone stimulation improved test accuracy (0.91 ± 0.06 to 0.97 ± 0.03, P = .004).

CONCLUSIONS AND CLINICAL IMPORTANCE

ACTH concentrations follow a circannual rhythm and vary with physiological factors. As using DCOVs increases the ability to detect mild cases and using RI decreases the risk of unnecessary treatments, ACTH concentrations should be interpreted within a specific clinical context. The TRH stimulation test improves the diagnosis of PPID.

Evaluation of Oxidative Stress Parameters in Healthy Saddle Horses in Relation to Housing Conditions, Presence of Stereotypies, Age, Sex and Breed

Oxidative stress plays an important role in the development of many horse diseases and it has been shown that housing has important implications for the psychophysical well-being of horses. The aim of this study is to determine if there are any differences between the redox status in horses in relation to housing conditions. The four housing conditions analyzed were: single box, without external access and without contact (Cat A), single box with external access and possibility of partial contact (Cat B), group housing with box and large paddock (Cat C), pasture with more than 7 horses and the possibility of green forage for the whole year (Cat D). A group of 117 healthy horses were selected in several private stables in Northern Italy. All subjects treated with any type of drug were excluded. At the end of the enrollment, the 117 selected horses were divided into the four housing categories. Stereotypies were highest in the group of horses in single box, without external access and without contact (Cat A). Oxidative stress was evaluated by testing plasma or serum samples for the following parameters: superoxide anion (WST), nitric oxide (NO), reactive oxygen species (d-ROMs), ferric reducing ability of plasma (FRAP), and the activity of superoxide dismutase (SOD). Simultaneously with the blood sampling, the owners completed a questionnaire with all the management aspects of the horse (signaling, feeding, equestrian activity, vaccinations, foot management etc.). The statistical evaluation was carried out based on the categories previously described, on the presence and absence of stereotypies and on some signaling data obtained from the questionnaire. There were no significant differences in the parameters analyzed between the categories. No significant redox status differences were detected based on the presence or absence of stereotypies. Interestingly, when the age was introduced as selection (<14 and >14 years old) parameter inside the categories, statistical significance was observed for some of the stress markers considered. Finally, independently of the housing conditions, the horses of the most two represented breeds exhibited different values of FRAP. All these aspects are commented in the discussion.

Relative Deficiency in Albumin Methionine Content is Associated With Decreased Antioxidant Capacity of Equine Plasma

Relative to other species, horses seem particularly susceptible to oxidative stress. Plasma albumin plays an important role in preventing oxidative damage, in part due to its methionine (MET) content. Equine albumin is highly unusual in that it contains no MET residues. Whether or not this causes deficient antioxidant capacity in equine plasma relative to that of other species has not yet been explored. The objective of this study was to compare the redox status of equine (no MET) to that of bovine (moderate amount of MET) plasma. Plasma was collected from healthy, nonpregnant Quarter Horse mares (n = 10) and adult, healthy, nonpregnant, dried Holstein cows (n = 15). Measures of total antioxidant capacity and oxidative stress were assessed for each plasma sample using multiple commercially available assays: total antioxidant capacity, thiol detection, thiobarbituric acid reactive substances, and advanced oxidation protein products. Plasma from horses had significantly (P < .05) lower thiol content and thiobarbituric and reactive substances and higher advanced oxidation protein products than plasma from cattle. A difference in total antioxidant capacity was not observed; however, our study was underpowered to establish a meaningful comparison. Based on these findings, the lack of MET in equine albumin appears to translate to a lower antioxidant capacity of equine plasma. Our findings are consistent with previous reports in other species that identify MET as having an important role in the antioxidant capacity of albumin. Our results also highlight the complex system of antioxidant defenses in plasma that counteract the harmful effects of oxidants.

Effects of Advanced Age, Pituitary Pars Intermedia Dysfunction and Insulin Dysregulation on Serum Antioxidant Markers in Horses

The study aims to assess the impact of age, pituitary pars intermedia dysfunction (PPID) and insulin dysregulation (ID) in horses on selected oxidative stress markers. The study includes 32 horses, divided into three groups: “young” adult group (aged 8–16 years old) “geriatric” group (aged 18–24 years old) and the “PPID” group (aged 15–31 years old). The PPID group was further divided into two subgroups: PPID ID+ and PPID ID− based on presence or absence of ID. We measured serum antioxidant stress markers in all horses: total oxidant status (TOS), total antioxidant capacity (TAC), ceruloplasmin (CER), lipofuscin (LPS), malondialdehyde (MDA) and thiols concentrations (containing sulfhydryl group -SH) as well as enzymatic systems: total superoxide dismutase (SOD), cytoplasmic SOD (CuZnSOD), mitochondrial SOD activity (MnSOD). Total serum thiols were significantly lower in the geriatric group and in the PPID group compared to the young group. The MnSOD concentration was higher in the PPID ID+ group compared to the PPID ID−. LPS and MDA concentrations were lower in the PPID ID+ group compared to the PPID ID− group. In the selected study groups of horses, older age, the presence of PPID and ID in the case of PPID had no effect on the studied oxidative stress markers.

Diagnostic orientation values for ACTH and other parameters for clinically healthy donkeys and mules (insulin, triglycerides, glucose, fructosamines, and ɣ-GT)

Pituitary pars intermedia dysfunction is the most prevalent endocrine disease in horses. Although donkeys and mules may also be affected, only a few data have been published. Reference values for diagnostic parameters, such as adrenocorticotropic hormone (ACTH), are especially scarce or even lacking. Therefore, in the present study, available data from the literature have been verified and completed to facilitate a reliable diagnosis. Clinical inspections and haematological and biochemical examinations were carried out four times in a three-month interval (February to November) in 44 donkeys and 31 mules. Data from clinically healthy animals were used as an orientation. Plasma ACTH concentrations showed seasonal changes in both animal groups. However, it was generally higher in donkeys than mules. Although blood glucose (EDTA plasma) showed no difference between groups, serum insulin concentrations were consistently higher in donkeys. Serum fructosamine levels were slightly higher in mules, whereas, in some cases, serum triglyceride levels were considerably higher in donkeys. Serum gamma-glutamyltransferase showed a striking peak in mules in August, whereas the remaining gamma-glutamyltransferase values were lower compared to donkeys. By comparing donkeys and mules, the present work reveals differences in various blood parameters which should be considered for diagnoses and future studies.

A review of recent developments in the pharmacological prevention and treatment of endocrinopathic laminitis

Despite the prevalence of endocrinopathic laminitis, the pharmacologic options for preventing and treating the disease are severely limited. The present review aims to discuss the spectrum of potential therapeutic agents for the condition, ranging from early experimental compounds to agents nearing registration. There are different pharmacologic targets for, and approaches to, managing laminitis. Reducing hyperinsulinaemia is central to diminishing endocrinopathic laminitis risk, and a detailed understanding of the pathophysiology of insulin dysregulation is necessary to identify pathways that can be targeted to minimise post-prandial insulin secretion and action. This area of research is advancing rapidly, with several exciting prospects, such as sodium-dependent glucose co-transporter-2 inhibitors, on the horizon for the treatment of equine metabolic dysfunction. Drugs that directly target the lamellae and aim to reduce the damage inflicted on the lamellae as part of this condition, are not yet available. Although progress in this area of laminitis therapy is slower, improved understanding of the events that lead to lamellar failure has enabled the investigation of novel drugs that aim to prevent laminitis at the site of the lesion. Finally, a brief review is included of the directions being taken in the management of the chronic and acute pain that accompanies laminitis. Medications for relieving the pain associated with laminitis are currently the most-prescribed drugs for the disease, and range from simple, affordable and thoroughly tested options, such as phenylbutazone, to newer, less-understood applications such as paracetamol and gabapentin. In the future, endocrinopathic laminitis management plans will likely take a multi-faceted approach that still hinge on effective dietary management and exercise, but also include drugs that address foot pathology, pain and underlying endocrine disturbances.

Hypertrichosis in a Horse with Alimentary T-Cell Lymphoma and Pituitary Involvement

A 13-year-old Quarterhorse mare had a 6-month history of diarrhea, progressive weight loss, and lethargy. At presentation the mare was hirsute, had hyperhidrosis, and abnormal fat distribution in addition to severe diarrhea. A presumptive clinical diagnosis of protein-losing enteropathy and pituitary pars intermedia dysfunction was made. T-cell lymphoma was diagnosed in a rectal biopsy specimen. The owner elected to euthanize the mare because of poor prognosis and the severity of the disease. At necropsy, the mare had hypertrichosis and the pituitary gland was diffusely enlarged. Histologically, neoplastic lymphocytes infiltrated the gastrointestinal mucosa, mesenteric lymph nodes, and the pituitary gland. In addition, there was hyperplasia of the pituitary gland pars intermedia. Pituitary adenoma was not present. Hypertrichosis in this case could have been triggered by a combination of adenomatous hyperplasia of pars intermedia and lymphoma resulting in disruption of the hypothalamic dopaminergic tone or disruption of the hypothalamic thermoregulatory center.

A quantitative approach to analysing cortisol response in the horse

The cortisol response to glucocorticoid intervention has, in spite of several studies in horses, not been fully characterized with regard to the determinants of onset, intensity and duration of response. Therefore, dexamethasone and cortisol response data were collected in a study applying a constant rate infusion regimen of dexamethasone (0.17, 1.7 and 17 μg/kg) to six Standardbreds. Plasma was analysed for dexamethasone and cortisol concentrations using UHPLC-MS/MS. Dexamethasone displayed linear kinetics within the concentration range studied. A turnover model of oscillatory behaviour accurately mimicked cortisol data. The mean baseline concentration range was 34-57 μg/L, the fractional turnover rate 0.47-1.5 1/h, the amplitude parameter 6.8-24 μg/L, the maximum inhibitory capacity 0.77-0.97, the drug potency 6-65 ng/L and the sigmoidicity factor 0.7-30. This analysis provided a better understanding of the time course of the cortisol response in horses. This includes baseline variability within and between horses and determinants of the equilibrium concentration-response relationship. The analysis also challenged a protocol for a dexamethasone suppression test design and indicated future improvement to increase the predictability of the test.

Effect of a single bout of exercise and chronic exercise training on insulin sensitivity in racing sled dogs

Two experiments were designed to investigate the role of exercise on insulin sensitivity (IS) in Alaskan racing sled dogs. In both experiments, IS was quantified with an isoglycemic-hyperinsulinemic clamp (IHC), whereby IS was defined as the glucose infusion rate (GIR) divided by the mean insulin concentration during the clamp. In Experiment 1, IS was quantified in 12 racing sled dogs during three stages of exercise training: unexercised for 4 months over the summer (deconditioned), and after two and four months of exercise conditioning. At each stage IS was assessed in unexercised dogs (n=6) and 60 h following a standard exercise challenge (n=6) consisting of a 35.4 km run completed in 2.5 h. In Experiment 2, IS was assessed in deconditioned dogs (n=6) and in well-conditioned dogs that had either completed a 708 km race 5-days prior (n=3) or were unraced for the previous month (n=3). In Experiment 1, there were no significant differences (Pã0.05) in GIR or IS between the three levels of conditioning, nor were there any effects of the exercise bout 60 h prior to the IHC. In Experiment 2 there was no significant difference in IS between well-conditioned dogs and untrained dogs (Pã0.05). However, dogs that completed a 708 km race 5-days prior to the IHC had a significantly higher IS than dogs that were deconditioned and those that were conditioned but unraced. These results suggest that the workload of an exercise challenge is a factor in post-exercise changes in IS but that exercise conditioning has little impact on IS in Alaskan sled dogs.

Therapeutic plasma concentrations of epsilon aminocaproic acid and tranexamic acid in horses

BACKGROUND

Antifibrinolytic drugs such as epsilon aminocaproic acid (EACA) and tranexamic acid (TEA) are used to treat various bleeding disorders in horses. Although horses are hypofibrinolytic compared to humans, dosing schemes have been derived from pharmacokinetic studies targeting plasma concentrations in humans.

HYPOTHESIS/OBJECTIVES

We hypothesized therapeutic plasma concentrations of antifibrinolytic drugs in horses would be significantly lower than in humans. Our objective was to use thromboleastography (TEG) and an in vitro model of hyperfibrinolysis to predict therapeutic concentrations of EACA and TEA in horses and humans.

ANIMALS

Citrated plasma collected from 24 random source clinically healthy research horses. Commercial pooled human citrated plasma with normal coagulation parameters was purchased.

METHODS

Minimum tissue plasminogen activator (tPA) concentration to induce complete fibrinolysis within 10 minutes was determined using serial dilutions of tPA in equine plasma. Results used to create an in vitro hyperfibrinolysis model with equine and human citrated plasma, and the minimum concentrations of EACA and TEA required to completely inhibit fibrinolysis for 30 minutes (estimated therapeutic concentrations) determined using serial dilutions of the drugs.

RESULTS

Estimated therapeutic concentrations of EACA and TEA were significantly lower in horses (5.82; 95% CI 3.77-7.86 μg/mL and 0.512; 95% CI 0.277-0.748 μg/mL) than in humans (113.2; 95% CI 95.8-130.6 μg/mL and 11.4; 95% CI 8.62-14.1 μg/mL).

CONCLUSIONS AND CLINICAL IMPORTANCE

Current dosing schemes for EACA and TEA in horses may be as much as 20× higher than necessary, potentially increasing cost of treatment and risk of adverse effects.

Plasma fructosamine concentrations in horses with pituitary pars intermedia dysfunction with and without laminitis

REASONS FOR PERFORMING STUDY

Plasma fructosamine concentration ([fructosamine]) is believed to reflect medium term, average blood glucose concentration and in a previous study was higher in horses with active laminitis than in normal horses. Pituitary pars intermedia dysfunction (PPID) is associated with hyperglycaemia and laminitis.

OBJECTIVES

To test the hypotheses that: [fructosamine] is higher in PPID cases than normal animals; furthermore, that within cases of PPID [fructosamine] is higher in those with active laminitis than nonlaminitic cases and in cases that have been affected by active laminitis in the preceding year than those that have not.

STUDY DESIGN

Observational, case-control/cross-sectional study.

METHODS

[Fructosamine] was measured in cases of PPID (n = 46) and normal animals (n = 139). A normal range was calculated; values were compared between the 2 groups and within the PPID group, between cases with and without active laminitis and between cases that had and had not been affected by active laminitis in the preceding year.

RESULTS

In normal animals mean [fructosamine] was 248.7 μmol/l; the normal range (mean ± 2 s.d.) was 195.5-301.9 μmol/l. Plasma [fructosamine] was not higher in PPID cases than in normal animals. In PPID cases, [fructosamine] was significantly (P = 0.006) higher in cases with active laminitis (mean ± s.d. 261.2 ± 39.2 μmol/l) compared with those without active laminitis (234.5 ± 32.9 μmol/), but [fructosamine] was not higher in cases that had been affected by active laminitis in the preceding year than those that had not.

CONCLUSIONS

In horses affected by PPID, [fructosamine] is higher in cases with active laminitis than in cases without active laminitis.

POTENTIAL RELEVANCE

Clinical use of [fructosamine] is limited due to overlap with the normal range. Further studies into glucose and protein metabolism in cases of PPID are warranted.

Association of the glycoxidative stress marker pentosidine with equine laminitis

Ponies suffering from recurrent episodes of laminitis when grazed at pasture (pasture-associated laminitis) exhibit phenotypes similar to those associated with human metabolic syndrome. In humans, evidence suggests that the obesity-related morbidities associated with metabolic syndrome, including diabetes and cardiovascular disease, are caused by an increase in the production of advanced glycoxidation end-products (AGEs). These end-products have been recognised as putative pro-inflammatory mediators and are considered a 'risk factor' for human health. However, the evaluation of AGEs in laminitic ponies has not been explored. The aim of this study was to compare plasma concentrations of the AGE pentosidine (PENT) in ponies presenting with clinical features of equine metabolic syndrome (EMS) with a history of recent laminitis and/or showing signs of laminitis at the time of sampling (LP) with those with no prior history of clinical laminitis (NL). Age, body condition score (BCS) and bodyweight were recorded and blood samples collected for the measurement of plasma concentrations of PENT, glucose, insulin, triglycerides (TG), non-esterified fatty acids (NEFA) and cortisol. Insulin sensitivity was assessed by the reciprocal of the square root of insulin (RISQI) and the insulin:glucose ratio. Plasma PENT concentrations were twofold higher (P<0.005) in LP than in NL ponies. Significant (P<0.05) correlations were also evident between PENT and insulin, RISQI, TG and age. These preliminary findings are consistent with the hypothesis that glycoxidation in laminitis is associated with EMS.

Short-term incubation of equine laminar veins with cortisol and insulin alters contractility in vitro: possible implications for the pathogenesis of equine laminitis

This study investigated the effects of cortisol and insulin, hormones that affect both glycaemic status and vascular function, on the in vitro contractility of isolated healthy equine small laminar veins. Small veins (150-500 μm) draining the digital laminae from healthy horses or ponies were investigated by wire myography. Concentration response curves were constructed for noradrenaline (NA), phenylephrine (PE), endothelin-1 (ET-1) and 5-hydroxytryptamine (5-HT) in the presence of either cortisol (10(-6 ) m) or insulin (1000 μIU/mL). Cortisol significantly increased the maximum contractility of laminar veins to the vasoconstrictors NA and 5-HT but decreased the maximal contraction to ET-1. Insulin decreased the contractility of vessels to PE and ET-1. It is possible that short-term cortisol excess could enhance venoconstrictor responses to 5-HT and NA in laminar veins in vivo, thereby predisposing to laminitis. Additionally, a reduction in the ability of insulin to counteract alpha-adrenoreceptor and ET-1-mediated contraction, likely to occur in subjects with insulin resistance, may further exacerbate venoconstriction in animals prone to laminitis. These mechanisms may also predispose horses with disorders such as equine Cushing's disease and equine metabolic syndrome to laminitis.

Histological and morphometric lesions in the pre-clinical, developmental phase of insulin-induced laminitis in Standardbred horses

Lamellar pathology in experimentally-induced equine laminitis associated with euglycaemic hyperinsulinaemia is substantial by the acute, clinical phase (∼48h post-induction). However, lamellar pathology of the developmental, pre-clinical phase requires evaluation. The aim of this study was to analyse lamellar lesions both qualitatively and quantitatively, 6, 12 and 24h after the commencement of hyperinsulinaemia. Histological and histomorphometrical analyses of lamellar pathology at each time-point included assessment of lamellar length and width, epidermal cell proliferation and death, basement membrane (BM) pathology and leucocyte infiltration. Archived lamellar tissue from control horses and those with acute, insulin-induced laminitis (48h) was also assessed for cellular proliferative activity by counting the number of cells showing positive nuclear immuno labelling for TPX2. Decreased secondary epidermal lamellar (SEL) width and increased histomorphological evidence of SEL epidermal basal (and supra-basal) cell death occurred early in disease progression (6h). Increased cellular proliferation in SELs, infiltration of the dermis with small numbers of leucocytes and BM damage occurred later (24 and 48h). Some lesions, such as narrowing of the SELs, were progressive over this time period (6-48h). Cellular pathology preceded leucocyte infiltration and BM pathology, indicating that the latter changes may be secondary or downstream events in hyperinsulinaemic laminitis.

Advanced glycation endproducts in horses with insulin-induced laminitis

Advanced glycation endproducts (AGEs) have been implicated in the pathogenesis of cancer, inflammatory conditions and diabetic complications. An interaction of AGEs with their receptor (RAGE) results in increased release of pro-inflammatory cytokines and reactive oxygen species (ROS), causing damage to susceptible tissues. Laminitis, a debilitating foot condition of horses, occurs in association with endocrine dysfunction and the potential involvement of AGE and RAGE in the pathogenesis of the disease has not been previously investigated. Glucose transport in lamellar tissue is thought to be largely insulin-independent (GLUT-1), which may make the lamellae susceptible to protein glycosylation and oxidative stress during periods of increased glucose metabolism. Archived lamellar tissue from horses with insulin-induced laminitis (n=4), normal control horses (n=4) and horses in the developmental stages (6h, 12h and 24h) of the disease (n=12) was assessed for AGE accumulation and the presence of oxidative protein damage and cellular lipid peroxidation. The equine-specific RAGE gene was identified in lamellar tissue, sequenced and is now available on GenBank. Lamellar glucose transporter (GLUT-1 and GLUT-4) gene expression was assessed quantitatively with qRT-PCR in laminitic and control horses and horses in the mid-developmental time-point (24 h) of the disease. Significant AGE accumulation had occurred by the onset of insulin-induced laminitis (48 h) but not at earlier time-points, or in control horses. Evidence of oxidative stress was not found in any group. The equine-specific RAGE gene was not expressed differently in treated and control animals, nor was the insulin-dependent glucose transporter GLUT-4. However, the glucose transporter GLUT-1 was increased in lamellar tissue in the developmental stages of insulin-induced laminitis compared to control horses and the insulin-independent nature of the lamellae may facilitate AGE formation. However, due to the lack of AGE accumulation during disease development and a failure to detect an increase in ROS or upregulation of RAGE, it appears unlikely that oxidative stress and protein glycosylation play a central role in the pathogenesis of acute, insulin-induced laminitis.

Equine pituitary pars intermedia dysfunction

Equine pituitary pars intermedia dysfunction (PPID), also known as equine Cushing's syndrome, is a widely recognized disease of aged horses. Over the past two decades, the aged horse population has expanded significantly and in addition, client awareness of PPID has increased. As a result, there has been an increase in both diagnostic testing and treatment of the disease. This review focuses on the pathophysiology and clinical syndrome, as well as advances in diagnostic testing and treatment of PPID, with an emphasis on those findings that are new since the excellent comprehensive review by Schott in 2002.

Role of oxidative tissue injury in the pathophysiology of experimentally induced equine laminitis: a comparison of 2 models

BACKGROUND

Oxidative stress reportedly plays a role in sepsis-induced organ dysfunction and failure in many species. In septic horses, laminae are targeted; evidence of laminar oxidative stress has been reported experimentally in the black walnut extract (BWE) model. Carbohydrate (CHO)-induced laminitis may be more similar to clinical sepsis-related laminitis than the BWE model in that animals with CHO-induced disease commonly develop laminar failure. The role of oxidative stress in the CHO model remains unknown.

HYPOTHESIS/OBJECTIVES

Markers of oxidative stress will be increased in laminae from horses with BWE- and CHO-induced laminitis.

ANIMALS

Banked laminar tissue from various time points from animals subjected to BWE (n = 15) and CHO (n = 20) protocols.

METHODS

Laminar 4-hydroxynonenal (4-HNE) and protein carbonyl content were evaluated by slot blot analysis. Laminar 3-nitrotyrosine (3-NT) immunohistochemistry was performed.

RESULTS

The number of laminar 3-NT (+) cells was increased at developmental and Obel grade 1 (OG1) time points in the BWE model (versus control [CON]; P= .013) and lower in OG1 tissues than CON in the CHO model (P = .04). No change in 4-HNE content was observed in the CHO model, and no increase in laminar protein carbonyl content was present in either model (P > .05).

CONCLUSIONS AND CLINICAL IMPORTANCE

These results do not support a prominent role for oxidative stress at examined time points in CHO-overload laminitis and support transient oxidative stress in the BWE model. Tissue oxidation does not appear to be a central early pathophysiologic event in CHO-associated laminitis.

Effect of exercise on blood oxidant/antioxidant markers in Standardbred horses: comparison between treadmill and race track tests

REASONS FOR PERFORMING STUDY

Interest in establishing oxidant/ antioxidant profiles in competition horses is increasing. Earlier studies performed in horses have mainly been performed under laboratory conditions using a treadmill and it is not known to what extent laboratory results of oxidant/antioxidant studies might be transposed to field conditions.

OBJECTIVE

To compare the impact on the blood oxidant/ antioxidant status of a standardised exercise test including a run up to fatigue performed on a treadmill (TM) and on a racetrack (RT) in healthy and trained Standardbred horses.

MATERIAL AND METHODS

During TM and RT tests the following blood antioxidant markers were analysed in jugular venous blood at rest and 15 mins (E15) after an intense bout of exercise: uric acid (UA), ascorbic acid (AA), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione (reduced: GSH and oxidised: GSSG), glutathione redox ratio (GRR) and protein thiol (PSH). Running time to fatigue (RTF), velocity during the last exercise stage (Vmax), final heart rate (HRfinal) and venous lactic acid (LA) were also recorded.

RESULTS

Vmax was significantly (P<0.05) higher during the RT, whereas LA was significantly lower. HRfinal and RTF did not differ significantly between TM and RT. Exercise induced a significant increase (R vs. E15) of UA and AA in both tests, whereas GSH and PSH decreased significantly. GPx, SOD, GSSG and GRR remained unchanged. Differences between TM and RT were significant at E15 for UA, AA and PSH.

CONCLUSIONS

Comparison of oxidant/antioxidant profiles from laboratory and field studies are difficult to standardise and should be interpreted with caution.

POTENTIAL RELEVANCE

For the same RTF and final HR, the TM induced stronger changes in blood lactate and in blood oxidant/antioxidant balance than did RT.

Evaluation of antioxidant systems in pituitary-adrenal axis diseases

The role of adrenal steroids in antioxidant regulation is not known. Previously, we demonstrated some Coenzyme Q(10) (CoQ(10)) alterations in pituitary diseases, which can induce complex pictures due to alterations of different endocrine axes. Therefore we determined CoQ(10) and Total Antioxidant Capacity (TAC) in pituitary-dependent adrenal diseases: 6 subjects with ACTH-dependent adrenal hyperplasia (AH); 19 with secondary isolated hypoadrenalism (IH), 19 with associated hypothyroidism (multiple pituitary deficiencies, MPH). CoQ(10) was assayed by HPLC; TAC by the system metmyoglobin-H(2)O(2), which, interacting with the chromogenous 2,2(I)-azinobis-(3-ethylbenzothiazoline-6-sulphonate), generates a spectroscopically revealed radical compound after a latency time (Lag) proportional to the antioxidant content. CoQ(10) levels were significantly lower in IH than AH and MPH, with a similar trend when adjusted for cholesterol. Also TAC was lower in IH than in AH and MPH, suggesting that adrenal hormones can influence antioxidants. However, since thyroid hormones modulate CoQ(10) levels and metabolism, when thyroid deficiency coexists it seems to play a prevalent influence.

Hormones and antioxidant systems: role of pituitary and pituitary-dependent axes

Oxidative stress, a condition defined as unbalancing between production of free radicals and antioxidant defenses, is an important pathogenetic mechanism in different diseases. Despite the abundant literature, many aspects of hormone role in regulating antioxidant synthesis and activity still remain obscure. Therefore, we reviewed experimental data, in vivo and in vitro, about the effects of the different pituitary- dependent axes on antioxidant levels, trying to give a broad view from hormones which also have antioxidant properties to the classic antioxidants, from the lipophilic antioxidant Coenzyme Q10, strictly related to thyroid function, to total antioxidant capacity, a measure of non-protein non-enzymatic antioxidants in serum and other biological fluids. Taken together, these data underline the importance of oxidative stress in various pituitary-dependent disorders, suggesting a possible clinical usefulness of antioxidant molecules.

Inflammatory and redox status of ponies with a history of pasture-associated laminitis

Inflammatory and redox signals could render lamellar tissue susceptible to damage and contribute to higher risk for laminitis in obese or insulin resistant ponies just as these factors contribute to health risks in humans with metabolic syndrome. This study evaluated circulating markers of inflammatory and redox status in ponies that had a history of recurrent bouts of pasture-associated laminitis (PL, n = 42) or had never developed clinical laminitis (NL, n = 34) under the current management conditions. There were no differences (P > 0.05) between PL and NL ponies for markers of antioxidant function (glutathione, glutathione peroxidase, superoxide dismutase) or increased oxidative pressure (malondialdehyde, apoptosis, 3-nitrotyrosine). Inflammatory status, as indicated by fibrinogen concentration, was also not different between pony groups (P = 0.84). However, PL ponies had higher (P < 0.001) plasma concentrations of the pro-inflammatory cytokine TNF-alpha than NL ponies. This suggests that a predisposition to laminitis is associated with increased circulating inflammatory cytokines. TNF-alpha could also represent a contributing factor to increased insulin resistance observed in laminitis prone ponies. These results provide new insight into potential mechanisms and risk factors underlying laminitis.

Oxidative stress

Oxidative stress refers to the cellular injury and pathologic change that occurs when there is an imbalance favoring oxidants over antioxidants within a living organism. In human medicine, oxidative stress has been implicated in numerous disease processes, which has led to further research into the clinical benefits and efficacy of antioxidant therapy. The evaluation of oxidative stress in the horse has been limited primarily to ischemia-reperfusion injury of the gastrointestinal tract, recurrent airway obstruction, exercise, osteoarthritis, equine motor neuron disease, and pituitary pars intermedia dysfunction. Each of these is examined in this review in terms of the current evidence for oxidative stress as well as the evidence for current antioxidant therapy in equine medicine and the potential of future research and therapies. Oxidative stress research is currently an emerging field with relevance to the equine critical patient.

Induction of laminitis by prolonged hyperinsulinaemia in clinically normal ponies

The purpose of this study was to determine the effects of prolonged administration of insulin, whilst maintaining normal glucose concentrations, on hoof lamellar integrity in vivo on healthy ponies with no known history of laminitis or insulin resistance. Nine clinically healthy, unrelated ponies were randomly allocated to either a treatment group (n =5; 5.9+/-1.7 years) or control group (n =4; 7.0+/-2.8 years). The treatment group received insulin via a euglycaemic hyperinsulinaemic clamp technique modified and prolonged for up to 72 h. Control ponies were infused with an equivalent volume of 0.9% saline. Ponies were euthanized at the Obel grade 2 stage of clinical laminitis and hoof lamellar tissues were harvested and examined for histopathological evidence of laminitis. Basal serum insulin and blood glucose concentrations were 15.7+/-1.8 microU/mL and 5.2+/-0.1 mmol/L, respectively (mean+/-SE) and were not significantly different between groups. Mean serum insulin concentration in treatment ponies was 1036+/-55 microU/mL vs. 14.6 microU/mL in controls. All ponies in the treatment group developed clinical and histological laminitis (Obel grade 2) in all four feet within 72 h (55.4+/-5.5h), whereas none of the control ponies developed laminitis. There was no clinical evidence of gastrointestinal involvement and the ponies showed no signs of systemic illness throughout the experiment. The data show that laminitis can be induced in healthy young ponies, with no prior history of laminitis, by maintaining prolonged hyperinsulinaemia with euglycaemia. This suggests a role for insulin in the pathogenesis of laminitis, independent of hyperglycaemia, or alterations in hind-gut fermentation. For the clinician, early detection and control of hyperinsulinaemia may facilitate management of endocrinopathic laminitis.

The oxidant/antioxidant equilibrium in horses

Since "free radical research" started in 1954, understanding the role of oxidants and antioxidants in physiological and pathological conditions has increased continuously. Oxidants are essentially generated by metabolic enzymes, inflammatory cells and mitochondrial electron leakage; they are indispensable for the cellular redox regulation and may, under certain conditions, have a pro-inflammatory stimulatory role. Endogenous and exogenous antioxidants counterbalance the oxidative processes and so maintain the oxidant/antioxidant equilibrium. Excessive oxidant generation or antioxidant insufficiency can lead to oxidative stress. The aims of this review are: (1) to provide an insight into the concept of the oxidant/antioxidant equilibrium by briefly introducing the oxidant and the antioxidant systems; (2) to describe how the oxidant/antioxidant equilibrium or oxidative stress can be evaluated in horses, and (3) to summarise current knowledge about oxidative stress in equine medicine and equine exercise physiology.

Evidence-based literature pertaining to thyroid dysfunction and Cushing's syndrome in the horse

The evidence-based literature pertaining to thyroid dysfunction and Cushing's syndrome is discussed in this article. Summaries of and recommendations for the treatment of these conditions are made. There is a need for reliable diagnostic tests for these conditions in horses.

Countermeasures for pasture-associated laminitis in ponies and horses

Laminitis occurs throughout the world in horses and ponies and has major welfare implications. It is obviously important to be able to recognize and treat the condition in its early stages so that pain and suffering are kept to a minimum. However, ideally it would be preferred to be able to recommend certain interventions/countermeasures that avoid or prevent the condition from occurring in the first place. Because pasture-associated laminitis occurs with grass consumption, one obvious way to avoid the condition is to prevent access to pasture and to feed forage alternatives that are known to be low in rapidly fermentable material. For the majority of horses, total restriction is not always a viable or desired option for financial, welfare, and health reasons. It also may not be necessary for those animals that are not predisposed to laminitis. This review discusses the possible countermeasures that could be considered now and in the future in the following 7 key areas: 1) Identifying animals predisposed to the condition; 2) Limiting development of insulin resistance; 3) Avoiding high intakes of rapidly fermentable material; 4) Preventing/reducing the formation and absorption of the various "triggering factors"; 5) Reducing/preventing oxidative damage; 6) Preventing/reducing matrix metalloproteinase activity; and 7) Preventing changes in blood flow. It is unfortunate that little or no hard data exist at present on effective countermeasures, only mechanistic evidence for avoiding risk factors. However, there is much to gain, and research in this area is urgently required.