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Lo Feudo CM, Stucchi L, Bazzocchi C, Consiglio AL, Comazzi S, Cozzi MC, Gusmara C, Gaspari G, Cialini C, Bizzotto D, Dellacà R, Ferrucci F. Cytokine mRNA expression in the bronchoalveolar lavage cells from horses affected by different equine asthma subtypes. J Equine Vet Sci 2024; 135:105033. [PMID: 38423374 DOI: 10.1016/j.jevs.2024.105033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
Equine asthma (EA) is a respiratory syndrome associated with the increase of different leukocyte populations in the bronchoalveolar lavage fluid (BALF). Its pathogenetic mechanisms remain unclear. This study aimed to evaluate the associations between the mRNA expression of different cytokines in the BALF, different EA subtypes and lung function. Fifteen horses underwent physical examination, airway endoscopy, BALF cytology and lung function testing (8/15). One horse did not have evidence of EA and was used as healthy reference, while the others were classified as affected by neutrophilic or mixed granulocytic EA. Cells isolated from the residual BALF were used for IL-1β, IL-2, IFN-γ, IL-4, IL-17A genes expression by quantitative RT-PCR., Cytokine expression was compared between groups, and their correlations with BALF leukocyte and lung function were evaluated. IL-1β expression was positively correlated with BALF neutrophils count (p=0.038, r=0.56) and with increased expiratory resistance (p=0.047, r=0.76). IFN-γ was correlated with BALF mast cells (p=0.029, r=0.58). IL-4 was higher in horses with mixed granulocytic EA than neutrophilic (p=0.008), positively correlated with BALF mast cells (p=0.028, r=0.59) and inversely with whole-breath (p=0.046, r=-0.76) and expiratory reactance (p=0.003, r=-0.93). Finally, IL-17A was inversely correlated with expiratory reactance (p=0.009, r=-0.92). These results support that multiple immune responses are involved in EA pathogenesis; innate, Th2, and Th17 responses. Innate immunity appeared associated with neutrophilic inflammation, and Th2 response with increased mast cells. The role of Th1 response in EA remains questionable.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Luca Stucchi
- Department of Veterinary Medicine, Università degli Studi di Sassari, Via Vienna 2, Sassari 07100, Italy.
| | - Chiara Bazzocchi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Anna Lange Consiglio
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Stefano Comazzi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Maria Cristina Cozzi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Claudia Gusmara
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Giulia Gaspari
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Chiara Cialini
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
| | - Davide Bizzotto
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Via Giuseppe Colombo 40, Milano 20133, Italy
| | - Raffaele Dellacà
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Via Giuseppe Colombo 40, Milano 20133, Italy
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Via dell'Università 6, Lodi 26900, Italy
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Lo Feudo CM, Stucchi L, Bizzotto D, Dellacà R, Lavoie JP, Ferrucci F. Respiratory oscillometry testing in relation to exercise in healthy and asthmatic Thoroughbreds. Equine Vet J 2024. [PMID: 38247256 DOI: 10.1111/evj.14065] [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: 11/29/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Racehorses may experience exercise-induced bronchodilation or bronchoconstriction, with potential differences between healthy and asthmatic individuals. OBJECTIVES To identify exercise-related lung function variations by oscillometry in racehorses, compare lung function between healthy and mild equine asthma (MEA) horses, assess oscillometry's potential as a predictor of racing fitness. STUDY DESIGN Prospective case-control clinical study. METHODS Fourteen Thoroughbred racehorses (5 healthy, 9 MEA) underwent a protocol including respiratory oscillometry at rest, exercise with fitness monitoring, oscillometry at 15 and 45 min post-exercise, and bronchoalveolar lavage fluid (BALf) cytology. Oscillometry parameters (resistance [Rrs] and reactance [Xrs]) were compared within and between healthy and MEA groups at different timepoints. Associations between Rrs and Xrs at rest and 15 min post-exercise and BALf cytology and fitness indices were evaluated. RESULTS MEA horses showed higher Rrs at 15 min post-exercise (0.6 ± 0.2 cmH2 O/L/s) than healthy horses (0.3 ± 0.1 cmH2 O/L/s) (p < 0.01). In healthy horses, Rrs decreased at 15 min post-exercise compared with resting values (0.5 ± 0.1 cmH2 O/L/s) (p = 0.04). In MEA horses, oscillometry parameters did not vary with time. Post-exercise Xrs inversely correlated with total haemosiderin score (p < 0.01, r2 = 0.51). Resting Rrs inversely correlated with speed at 200 bpm (p = 0.03, r2 = -0.61), and Xrs with maximum heart rate (HR) during exercise (p = 0.02, r2 = -0.62). Post-exercise Rrs inversely correlated with mean (p = 0.04, r2 = -0.60) and maximum speed (p = 0.04, r2 = -0.60), and HR variability (p < 0.01, r2 = -0.74). MAIN LIMITATIONS Small sample size, oscillometry repeatability not assessed, potential interference of upper airway obstructions, external variables influencing fitness indices. CONCLUSIONS Oscillometry identified lung function differences between healthy and MEA horses at 15 min post-exercise. Only healthy horses exhibited exercise-induced bronchodilation. Oscillometry showed potential in predicting subclinical airway obstruction.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Lodi, Italy
| | - Luca Stucchi
- Department of Veterinary Medicine, Università degli Studi di Sassari, Sassari, Italy
| | - Davide Bizzotto
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy
| | - Raffaele Dellacà
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Lodi, Italy
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Simões J, Tilley P. Decision Making in Severe Equine Asthma-Diagnosis and Monitoring. Animals (Basel) 2023; 13:3872. [PMID: 38136909 PMCID: PMC10740644 DOI: 10.3390/ani13243872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Decision making consists of gathering quality data in order to correctly assess a situation and determine the best course of action. This process is a fundamental part of medicine and is what enables practitioners to accurately diagnose diseases and select appropriate treatment protocols. Despite severe equine asthma (SEA) being a highly prevalent lower respiratory disease amongst equids, clinicians still struggle with the optimization of routine diagnostic procedures. The use of several ancillary diagnostic tests has been reported for disease identification and monitoring, but many are only suitable for research purposes or lack practicality for everyday use. The aim of this paper is to assist the equine veterinarian in the process of decision making associated with managing SEA-affected patients. This review will focus on disease diagnosis and monitoring, while also presenting a flow-chart which includes the basic data that the clinician must obtain in order to accurately identify severely asthmatic horses in their everyday routine practice. It is important to note that European and American board-certified specialists on equine internal medicine can provide assistance in the diagnosis and treatment plan of SEA-affected horses.
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Affiliation(s)
- Joana Simões
- Equine Health and Welfare Academic Division, Faculty of Veterinary Medicine, Lusófona University, Campo Grande 376, 1749-024 Lisbon, Portugal
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4Animals), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - Paula Tilley
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal;
- Associate Laboratory for Animal and Veterinary Sciences (AL4Animals), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
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Robins TJ, Bedenice D, Mazan M. A Longitudinal Analysis of Equine Asthma Presentation and Response to Treatment Using Lung Function Testing and BAL Cytology Analysis in Combination with Owner Perception. Animals (Basel) 2023; 13:3387. [PMID: 37958142 PMCID: PMC10649418 DOI: 10.3390/ani13213387] [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: 09/01/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
(1) Background: Equine asthma (EA) is a pervasive and important cause of poor performance and respiratory morbidity in horses. Diagnosis of EA includes an owner complaint, clinical scoring, lung function testing, and cytological analysis of bronchoalveolar lavage (BAL) cytology. There is a paucity of information about the longitudinal course of the disease using these outcome assessments; thus, this study sought to describe and quantify, in horses with more than one visit to a specialty pulmonary clinic in New England, the type and range of clinical presentations with an eventual diagnosis of EA. It also aimed to develop and compare the outcomes of scoring systems for owner complaints and veterinary assessments, document and assess the diagnostic methods used, and evaluate the response of the horses to treatment and time. (2) Methods: This study was a retrospective, cross-sectional, STROBE-compliant observational analysis of equine patients who visited the Tufts Cummings Hospital for Large Animals (HLA) for evaluation of equine asthma (EA) from 1999-2023. The horses were categorized as having mild-moderate (mEA) or severe EA (sEA) using the ACVIM consensus statement guidelines. After excluding those with inadequate documentation or only one visit (n = 936), a total of 76 horses were included in the study. Of the 197 visits, 138 (70.0%) resulted in a diagnosis of mEA and 45 (22.8%) resulted in a diagnosis of sEA. Demographic information, owner complaints, clinical examination and scoring, lung function testing, BAL cytology, and recommendations for environmental remediation and pharmacologic treatment were recorded for all the visits. The data were analyzed for agreement between owner complaints (complaint score, CS) and clinical examination findings (examination score, ES), changes in CS and ES, lung function testing, and BAL cytology over time, with 197 visits recorded. (3) Results: A comparison between the CS and ES showed that the owners were more likely than veterinarians to detect cough, and a decrease in cough was the most common owner observation after treatment. The response to the histamine challenge, used to detect airway hyperreactivity, was significantly improved with treatment or time in the horses with mEA, whereas baseline lung function did not significantly change in mEA or sEA. (4) Conclusions: Owners can be astute observers of clinical signs, especially cough, in EA. Tests of airway hyperreactivity are more successful in detecting changes in mEA than are baseline lung function testing and assessment of BAL cytology.
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Affiliation(s)
| | | | - Melissa Mazan
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA
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5
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Kozłowska N, Wierzbicka M, Pawliński B, Domino M. Co-Occurrence of Severe Equine Asthma and Palatal Disorders in Privately Owned Pleasure Horses. Animals (Basel) 2023; 13:1962. [PMID: 37370472 DOI: 10.3390/ani13121962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
According to the "unified or united airway disease" theory, diseases in the upper and lower airways frequently co-occur because they represent a single morphological and functional unit. Palatal disorders (PDs) and severe equine asthma (SEA) are frequent diseases that, respectively, affect upper and lower equine airways; however, clinical studies focusing on the co-occurrence of PDs and SEA are limited. The present study investigated the prevalence of PDs in horses affected by SEA, and whether prevalence decreased after SEA treatment. Forty-six privately owned horses affected by SEA in exacerbation were included. For each horse, the severity of the asthma clinical signs was assessed using a previously described scoring system, and the co-occurrence of palatal disorders was investigated using overground endoscopy, before and after treatment for SEA. Before treatment (in exacerbation), 67.4% of SEA-affected horses showed evidence of PDs, including 39.1% showing evidence of palatal instability (PI) and 28.3% of dorsal displacement of the soft palate (DDSP). Airway inflammation (neutrophil percentage in the tracheal wash and bronchoalveolar lavage fluid) was worse in horses with co-occurring PDs. After treatment (in remission), no horses showed evidence of PI, while DDSP was diagnosed in 8.7% of horses. These findings suggest that palatal disorders respond to asthma treatment, supporting the hypothesis that both diseases could be manifestation of a common underlying disorder.
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Affiliation(s)
- Natalia Kozłowska
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Małgorzata Wierzbicka
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Bartosz Pawliński
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Małgorzata Domino
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
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Woodrow JS, Hines M, Sommardahl C, Flatland B, Lo Y, Wang Z, Sheats MK, Lennon EM. Initial investigation of molecular phenotypes of airway mast cells and cytokine profiles in equine asthma. Front Vet Sci 2023; 9:997139. [PMID: 36713876 PMCID: PMC9875299 DOI: 10.3389/fvets.2022.997139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/23/2022] [Indexed: 01/13/2023] Open
Abstract
Equine asthma is a naturally occurring lung disease characterized by chronic, partially reversible airway obstruction, pulmonary remodeling, and lower airway inflammation. Asthma is currently divided into two major groups, mild to moderate asthma (mEA) and severe asthma (sEA), but further subtyping by phenotype (i.e., clinical presentation) and/or endotype (i.e., cellular mechanisms) may be warranted. For this study, we were interested in further investigation of cellular and inflammatory characteristics of EA, including airway mast cells. The purpose of this study was to: (1) compare mast cell protease mRNA expression between healthy and asthmatic horses, (2) analyze the cytokine profile present in BALF of currently defined equine asthma groups, and (3) use these data to evaluate potential biomarkers of defined asthma groups. We hypothesized that there would be significant differences in the cellular mast cell phenotypes (i.e., mucosal vs. connective tissue) and cytokine profiles in the BALF of asthmatic vs. healthy horses and across asthma groups. We assert these characteristics may inform additional subtypes of equine asthma. Adult horses were recruited from the institution's teaching herd and clinical caseload. Mast cell protease gene expression of the BALF cellular component and multiplex bead immunoassay for cytokine concentrations in the BALF supernatant were investigated. Airway mast cells primarily expressed tryptase, with low levels of chymase. No significant changes in protease expression were detected across groups. Horses with severe asthma had increased TNF-α, CXCL-8, and IFN-γ concentrations in BALF supernatant. Multidimensional analysis demonstrated healthy and mEA horses have overlapping characteristics, with sEA separating from the other groups. This difference was primarily due to BALF neutrophil and lymphocyte concentrations. These study results further inform understanding of EA immunopathology, and future studies designed to investigate asthma phenotypes and endotypes. Ultimately, a better understanding of these groups could help identify novel therapeutic strategies.
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Affiliation(s)
- Jane S. Woodrow
- Department of Comparative and Experimental Medicine, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States,Department of Clinical Sciences and Advanced Medicine, College of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Melissa Hines
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Carla Sommardahl
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Bente Flatland
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Yancy Lo
- Bioinformatics Core, Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhiping Wang
- Bioinformatics Core, Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Mary Katie Sheats
- Department of Clinical Sciences, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Elizabeth M. Lennon
- Department of Clinical Sciences and Advanced Medicine, College of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States,*Correspondence: Elizabeth M. Lennon ✉
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Akula S, Riihimäki M, Waern I, Åbrink M, Raine A, Hellman L, Wernersson S. Quantitative Transcriptome Analysis of Purified Equine Mast Cells Identifies a Dominant Mucosal Mast Cell Population with Possible Inflammatory Functions in Airways of Asthmatic Horses. Int J Mol Sci 2022; 23:ijms232213976. [PMID: 36430453 PMCID: PMC9692376 DOI: 10.3390/ijms232213976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Asthma is a chronic inflammatory airway disease and a serious health problem in horses as well as in humans. In humans and mice, mast cells (MCs) are known to be directly involved in asthma pathology and subtypes of MCs accumulate in different lung and airway compartments. The role and phenotype of MCs in equine asthma has not been well documented, although an accumulation of MCs in bronchoalveolar lavage fluid (BALF) is frequently seen. To characterize the phenotype of airway MCs in equine asthma we here developed a protocol, based on MACS Tyto sorting, resulting in the isolation of 92.9% pure MCs from horse BALF. We then used quantitative transcriptome analyses to determine the gene expression profile of the purified MCs compared with total BALF cells. We found that the MCs exhibited a protease profile typical for the classical mucosal MC subtype, as demonstrated by the expression of tryptase (TPSB2) alone, with no expression of chymase (CMA1) or carboxypeptidase A3 (CPA3). Moreover, the expression of genes involved in antigen presentation and complement activation strongly implicates an inflammatory role for these MCs. This study provides a first insight into the phenotype of equine MCs in BALF and their potential role in the airways of asthmatic horses.
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Affiliation(s)
- Srinivas Akula
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, SE-750 07 Uppsala, Sweden
| | - Miia Riihimäki
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Ida Waern
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, SE-750 07 Uppsala, Sweden
| | - Magnus Åbrink
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, SE-750 07 Uppsala, Sweden
| | - Amanda Raine
- Science for Life Laboratory, Department of Medical Sciences, Uppsala University, SE-752 36 Uppsala, Sweden
| | - Lars Hellman
- Department of Cell and Molecular Biology, The Biomedical Center, Uppsala University, SE-751 24 Uppsala, Sweden
| | - Sara Wernersson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, P.O. Box 7011, SE-750 07 Uppsala, Sweden
- Correspondence: ; Tel.: +46-(0)1-8672-112
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8
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Kinnison T, McGilvray TA, Couëtil LL, Smith KC, Wylie CE, Bacigalupo SA, Gomez-Grau E, Cardwell JM. Mild-moderate equine asthma: A scoping review of evidence supporting the consensus definition. Vet J 2022; 286:105865. [PMID: 35817389 DOI: 10.1016/j.tvjl.2022.105865] [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: 01/18/2022] [Revised: 05/09/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
Current consensus defines mild-moderate equine asthma (mEA; previously inflammatory airway disease) by a hierarchy of indicators of lung pathology: cough, poor performance, increased tracheobronchial mucus, inflammatory bronchoalveolar lavage (BAL) cytology and pulmonary dysfunction. Exclusion criteria include fever, systemic disease, or increased resting respiratory effort. The aim of this review was to inform future research by identifying gaps, strengths and weaknesses in the current body of evidence supporting this consensus-proposed definition. Objectives were to critique evidence supporting the inclusion of each diagnostic indicator in the case definition, by summarising and evaluating evidence for its association with higher-level indicators of lung inflammation. Searches of three databases identified 2275 articles relating to mEA or its diagnostic indicators, from which 298 full-text articles were screened and 45 reviewed in full. Studies (n = 44) had been performed worldwide in clinics, hospitals, racetracks, yards or research herds, in 6092 horses. Studies were predominantly opportunistic observational (n = 13/44: 29.5%) or cross-sectional (n = 11/44; 25%). The median number of horses per study was 74. Where breed and use were reported most were Thoroughbreds (58.2%; 2730/4688) and racehorses (72.8%; n = 3960/5439). Domains rated as high risk of bias in almost 50% of articles were 'study power' and 'masking'. Heterogeneity in clinical and laboratory measures precluded meta-analysis. Evidence was more consistent for certain pairwise relationships (e.g., between cough and tracheobronchial mucus) than others (e.g., BAL cytology and lung function). Findings highlight the need for increased standardisation of diagnostic methods and reporting to facilitate future systematic review and meta-analysis.
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Affiliation(s)
- T Kinnison
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK.
| | - T A McGilvray
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - L L Couëtil
- Purdue University College of Veterinary Medicine, 625 Harrison Street, West Lafayette, IN 47907, USA
| | - K C Smith
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - C E Wylie
- Rossdales Equine Hospital, Cotton End Road, Exning, Newmarket, Suffolk CB8 7NN, UK
| | - S A Bacigalupo
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - E Gomez-Grau
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - J M Cardwell
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
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9
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Lo Feudo CM, Stancari G, Collavo F, Stucchi L, Conturba B, Zucca E, Ferrucci F. Upper and Lower Airways Evaluation and Its Relationship with Dynamic Upper Airway Obstruction in Racehorses. Animals (Basel) 2022; 12:1563. [PMID: 35739899 PMCID: PMC9219429 DOI: 10.3390/ani12121563] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022] Open
Abstract
Dynamic upper airway obstructions (DUAO) are common in racehorses, but their pathogenetic mechanisms have not been completely clarified yet. Multiple studies suggest that alterations of the pharyngo-laryngeal region visible at resting endoscopy may be predictive of the onset of DUAO, and the development of DUAO may be associated with pharyngeal lymphoid hyperplasia (PLH), lower airway inflammation (LAI) and exercise-induced pulmonary hemorrhage (EIPH). The present study aims to investigate the possible relationship between the findings of a complete resting evaluation of the upper and lower airways and DUAO. In this retrospective study, 360 racehorses (Standardbreds and Thoroughbreds) referred for poor performance or abnormal respiratory noises were enrolled and underwent a diagnostic protocol including resting and high-speed treadmill endoscopy, cytological examination of the bronchoalveolar lavage fluid and radiographic assessment of the epiglottis length. In this population, epiglottis flaccidity was associated with dorsal displacement of the soft palate, while no relationship was detected between DUAO and epiglottis length. No associations were detected between DUAO and PLH, LAI or EIPH. In conclusion, it is likely that epiglottis plays a role in upper airway stability, while airways inflammation does not seem to be involved in the pathogenesis of DUAO.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.Z.)
| | - Giovanni Stancari
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (G.S.); (L.S.); (B.C.)
| | - Federica Collavo
- Freelance DVM, Rheinbacher Straße 24, 53919 Weilerswist, Germany;
| | - Luca Stucchi
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (G.S.); (L.S.); (B.C.)
| | - Bianca Conturba
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (G.S.); (L.S.); (B.C.)
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.Z.)
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.Z.)
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10
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Kozłowska N, Wierzbicka M, Jasiński T, Domino M. Advances in the Diagnosis of Equine Respiratory Diseases: A Review of Novel Imaging and Functional Techniques. Animals (Basel) 2022; 12:381. [PMID: 35158704 PMCID: PMC8833607 DOI: 10.3390/ani12030381] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 02/04/2023] Open
Abstract
The horse, as a flight animal with a survival strategy involving rapid escape from predators, is a natural-born athlete with enormous functional plasticity of the respiratory system. Any respiratory dysfunction can cause a decline in ventilation and gas exchange. Therefore, respiratory diseases often lead to exercise intolerance and poor performance. This is one of the most frequent problems encountered by equine internists. Routine techniques used to evaluate respiratory tract diseases include clinical examination, endoscopic examination, radiographic and ultrasonographic imaging, cytological evaluation, and bacterial culture of respiratory secretions. New diagnostic challenges and the growing development of equine medicine has led to the implementation of advanced diagnostic techniques successfully used in human medicine. Among them, the use of computed tomography (CT) and magnetic resonance (MR) imaging significantly broadened the possibilities of anatomical imaging, especially in the diagnosis of upper respiratory tract diseases. Moreover, the implementation of spirometry, electrical impedance tomography (EIT), and impulse oscillation system (IOS) sheds new light on functional diagnostics of respiratory tract diseases, especially those affecting the lower part. Therefore, this review aimed to familiarize the clinicians with the advantages and disadvantages of the advanced diagnostic techniques of the equine respiratory tract and introduce their recent clinical applications in equine medicine.
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Affiliation(s)
| | - Małgorzata Wierzbicka
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (N.K.); (T.J.)
| | | | - Małgorzata Domino
- Department of Large Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland; (N.K.); (T.J.)
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11
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Bizzotto D, Paganini S, Stucchi L, Palmisano Avallone M, Ramirez EM, Pompilio PP, Ferrucci F, Lavoie JP, Dellaca RL. A portable fan-based device for evaluating lung function in horses by the forced oscillation technique. Physiol Meas 2022; 43. [PMID: 35120344 DOI: 10.1088/1361-6579/ac522e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/04/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The assessment of lung mechanics in horses is nowadays based on invasive methods that may require sedation. The forced oscillation technique (FOT) allows the non-invasive assessment of respiratory mechanics during spontaneous breathing, but current devices are complex, cumbersome, expensive, and difficult to be applied in horses. APPROACH We developed a portable FOT device based on a novel approach in which the pressure waveforms are generated by a servo-controlled ducted fan. This new approach allows the design of devices that are more sturdy, compact, and portable compared to already existing approaches. The prototype includes 1) a small microcontroller-based electronic board for controlling the fan and measuring flow and pressure and 2) an optimized data processing algorithm. MAIN RESULTS This device provides a maximum error of 0.06 cmH2O∙s/L and 0.15 cmH2O∙s/L in measuring respiratory resistance and reactance during in-vitro validation. A pilot study was also performed on three healthy horses and three horses with severe equine asthma (SEA) and it demonstrated good tolerability and feasibility of the new device. Total respiratory system resistance (Rrs) and reactance (Xrs) significantly differed (p<0.05) between groups. At 5Hz, Rrs was 0.66±0.02 cmH2O∙s/L and 0.94±0.07 cmH2O∙s/L in healthy and in SEA, respectively. Xrs 0.38±0.02 cmH2O∙s/L and -0.27±0.05 cmH2O∙s/L. SIGNIFICANCE This novel approach for applying FOT allowed the development of a small, affordable and portable device for the non-invasive evaluation of respiratory mechanics in spontaneously breathing horses, providing a useful new tool for improving veterinary respiratory medicine. Moreover, our results provide supporting evidence of the value of this novel approach for developing portable FOT devices also for applications in humans.
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Affiliation(s)
- Davide Bizzotto
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, 20133, ITALY
| | - Stefano Paganini
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, Milano, 20133, ITALY
| | - Luca Stucchi
- Equine Sports Medicine Lab (ESM-Lab), Università degli Studi di Milano Dipartimento di Medicina Veterinaria, Via dell'Università, 6, 26900 Lodi LO, Lodi, Lombardia, 26900, ITALY
| | - Matteo Palmisano Avallone
- DEIB, Politecnico di Milano Dipartimento di Elettronica Informazione e Bioingegneria, Via Giuseppe Colombo, 40, Milano, Milano, 20133, ITALY
| | - Esther Millares Ramirez
- Equine Asthma Laboratory, Université de Montréal Faculté de médecine vétérinaire, 3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada, Saint Hyacinthe, Quebec, J2S 7C6, CANADA
| | - Pasquale P Pompilio
- Restech srl, Via Melchiorre Gioia, 61, 20124 Milano MI, Milano, 20124, ITALY
| | - Francesco Ferrucci
- Equine Sports Medicine Lab (ESM-Lab), Università degli Studi di Milano Dipartimento di Medicina Veterinaria, Via dell'Università, 6, 26900 Lodi LO, Lodi, Lombardia, 26900, ITALY
| | - Jean-Pierre Lavoie
- Equine Asthma Laboratory, Université de Montréal Faculté de médecine vétérinaire, 3200 Rue Sicotte, Saint-Hyacinthe, QC J2S 2M2, Canada, Saint Hyacinthe, Quebec, J2S 2M2, CANADA
| | - Raffaele L Dellaca
- DEIB, Politecnico di Milano Dipartimento di Elettronica e Informazione, Via Giuseppe Colombo, 40, Milano, Milano, Lombardia, 20133, ITALY
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12
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Stucchi L, Ferrucci F, Bullone M, Dellacà RL, Lavoie JP. Within-Breath Oscillatory Mechanics in Horses Affected by Severe Equine Asthma in Exacerbation and in Remission of the Disease. Animals (Basel) 2021; 12:ani12010004. [PMID: 35011110 PMCID: PMC8749667 DOI: 10.3390/ani12010004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 12/19/2022] Open
Abstract
Oscillometry is a technique that measures the resistance (R) and the reactance (X) of the respiratory system. In humans, analysis of inspiratory and expiratory R and X allows to identify the presence of tidal expiratory flow limitation (EFLt). The aim of this study was to describe inspiratory and expiratory R and X measured by impulse oscillometry system (IOS) in horses with severe asthma (SEA) when in clinical remission (n = 7) or in exacerbation (n = 7) of the condition. Seven healthy, age-matched control horses were also studied. Data at 3, 5, and 7 Hz with coherence > 0.85 at 3 Hz and >0.9 at 5 and 7 Hz were considered. The mean, inspiratory and expiratory R and X and the difference between inspiratory and expiratory X (ΔX) were calculated at each frequency. The data from the three groups were statistically compared. Results indicated that in horses during exacerbation of severe asthma, X during expiratory phase is more negative than during inspiration, such as in humans in presence of EFLt. The evaluation of X during inspiration is promising in discriminating between horses with SEA in remission and control horses.
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Affiliation(s)
- Luca Stucchi
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy;
| | - Francesco Ferrucci
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, 26900 Lodi, Italy;
- Correspondence:
| | - Michela Bullone
- Dipartimento di Scienze Veterinarie, Università di Torino, 10095 Grugliasco, Italy;
| | - Raffaele L. Dellacà
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milano, Italy;
| | - Jean Pierre Lavoie
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
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13
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Bessonnat A, Hélie P, Grimes C, Lavoie JP. Airway remodeling in horses with mild and moderate asthma. J Vet Intern Med 2021; 36:285-291. [PMID: 34877706 PMCID: PMC8783337 DOI: 10.1111/jvim.16333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022] Open
Abstract
Background There is a remodeling of the central airways in horses with severe asthma but whether a similar process occurs in horses with the mild or moderate asthma (MMA) is unknown. Objectives To evaluate lesions affecting the central airways of horses with MMA. Animals Twelve horses with MMA and 8 control horses. Methods Case‐control retrospective study of horses classified as MMA affected or controls based on history and bronchoalveolar lavage fluid cytology. Endobronchial biopsies were analyzed using histomorphometry and a semiquantitative histologic scoring system. Results Histomorphometry identified epithelial hyperplasia (47 μm2/μm [34‐57 μm2/μm]; P = .02), a thickened lamina propria (166 μm [73‐336 μm]; P = .04), and smooth muscle fibrosis (42% [33%‐78%]; P = .04) in horses with MMA when compared to controls horses (24 μm2/μm [21‐80 μm2/μm]; 76 μm [36‐176 μm]; and 33% [26%‐52%], respectively). The semiquantitative score results indicated, in horses with MMA, the presence of epithelial hyperplasia (7 of the 12 horses with MMA and only 1 of the 8 control horses had a score of 1/1), and submucosal inflammatory leucocytes in the central airway (11 of the 12 horses with MMA and only 4 of the 8 control horses had a score ≥ 1/2). Conclusions and Clinical Relevance Tissue remodeling of the bronchial lamina propria, epithelium, and smooth muscle was present in horses with MMA.
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Affiliation(s)
- Amandine Bessonnat
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Pierre Hélie
- Faculty of Veterinary Medicine, Department of Pathology and Microbiology, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Carolyn Grimes
- Faculty of Veterinary Medicine, Department of Pathology and Microbiology, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
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14
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Herteman N, Mosing M, Waldmann AD, Gerber V, Schoster A. Exercise-induced airflow changes in horses with asthma measured by electrical impedance tomography. J Vet Intern Med 2021; 35:2500-2510. [PMID: 34505734 PMCID: PMC8478024 DOI: 10.1111/jvim.16260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Equine asthma (EA) causes airflow impairment, which increases in severity with exercise. Electrical impedance tomography (EIT) is an imaging technique that can detect airflow changes in standing healthy horses during a histamine provocation test. OBJECTIVES To explore EIT-calculated flow variables before and after exercise in healthy horses and horses with mild-to-moderate (MEA) and severe equine asthma (SEA). ANIMALS Nine healthy horses 9 horses diagnosed with MEA and 5 with SEA were prospectively included. METHODS Recordings were performed before and after 15 minutes of lunging. Absolute values from global and regional peak inspiratory (PIF, positive value) and expiratory (PEF, negative value) flows were calculated. Data were analyzed using a mixed model analysis followed by Bonferroni's multiple comparisons test to evaluate the impact of exercise and diagnosis on flow indices. RESULTS Control horses after exercise had significantly lower global PEF and PIF compared to horses with SEA (mean difference [95% confidence interval, CI]: 0.0859 arbitrary units [AU; 0.0339-0.1379], P < .001 and 0.0726 AU [0.0264-0.1188], P = .001, respectively) and horses with MEA (0.0561 AU [0.0129-0.0994], P = .007 and 0.0587 AU [0.0202-0.0973], P = .002, respectively). No other significant differences were detected. CONCLUSIONS AND CLINICAL IMPORTANCE Electrical impedance tomography derived PIF and PEF differed significantly between healthy horses and horses with SEA or MEA after exercise, but not before exercise. Differences between MEA and SEA were not observed, but the study population was small.
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Affiliation(s)
- Nicolas Herteman
- Clinic for Equine Internal Medicine, Equine Hospital, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Martina Mosing
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Andreas D Waldmann
- Department of Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany
| | - Vinzenz Gerber
- Equine Clinic, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Berne, Switzerland
| | - Angelika Schoster
- Clinic for Equine Internal Medicine, Equine Hospital, Vetsuisse Faculty, University of Zurich, Switzerland
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15
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Hansen S, Laustsen L, Otten ND, Skovgaard K, Bech R, Byrgesen S, Hopster-Iversen C, Fjeldborg J. Evaluation of Treatment With Respiratory Gene Technology and Serum in a Group of Standard Bred Racehorses With Cytological Evidence of Mild Equine Asthma. J Equine Vet Sci 2021; 101:103435. [PMID: 33993937 DOI: 10.1016/j.jevs.2021.103435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/20/2022]
Abstract
Alternative treatment options to glucocorticoids for equine asthma is desirable due to withdrawal time. The objective was to evaluate if serum and Respiratory Gene Technology (RGT), a commercial kit to produce autologous conditioned serum, was effective in reducing bronchoalveolar lavage (BAL) neutrophils and mast cells in racehorses with cytological evidence of mild equine asthma . Thirty-six Standardbred trotters in active training were enrolled in this randomized clinical trial; a healthy control group (n=11), a RGT group (n=12) and a serum group (n=13). Endoscopy including tracheal wash (TW) and BAL was performed before (T0), after a 6-week treatment period including 12 intramuscular injections of RGT or serum (T6) and as a follow-up 10 weeks after treatment (T16). A significant decrease in BAL neutrophils for the RGT group was found between T0 and T6 (P = .002, d=-1.51, CI: -2.43;-0.59) and for the serum group between T0-T6 (P = .002, d=-1.36, CI: -2.26;-0.46). Further, a significant decrease in BAL mast cells between T0-T6 for the both the RGT group (P = .019, d=-1.23, CI: -1.22;-0.34) and the serum group (P= .004, d=-0.81, CI: -1.65;0.04), and further between T0-T16 (RGT P= .011, d=-1.55, CI: -2.62;-0.48; serum P= .044, d=-0.65, CI: -1.68;-0.37). No significant difference in TW cytology was found for any of the time-points. Pro- and anti-inflammatory cytokines were regulated according to treatment. The control group showed no cytological differences between any time-point. Study results showed that intramuscular treatment with both RGT and serum was effective associated with reduction of BAL neutrophils and mast cells in horses with cytological evidence of mild equine asthma. Further large-scale studies are necessary.
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Affiliation(s)
- Sanni Hansen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup.
| | | | - Nina D Otten
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary and Animal Sciences, DK Frederiksberg C
| | - Kerstin Skovgaard
- Technical University of Denmark, Department of Biotechnology and Biomedicine, DK Kongens Lyngby
| | - Rune Bech
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Simon Byrgesen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Charlotte Hopster-Iversen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Julie Fjeldborg
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
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16
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Dixon CE, Bedenice D, Mazan MR. Comparison of Flowmetric Plethysmography and Forced Oscillatory Mechanics to Measure Airway Hyperresponsiveness in Horses. Front Vet Sci 2021; 7:511023. [PMID: 33693040 PMCID: PMC7937713 DOI: 10.3389/fvets.2020.511023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 09/18/2020] [Indexed: 11/13/2022] Open
Abstract
Airway hyperresponsiveness (AHR) is linked to airway inflammation and is considered a key manifestation of mild/moderate equine asthma (EA). The study purpose was to determine whether two modalities of non-invasive lung function testing (FOM-forced oscillatory mechanics vs. FP-flowmetric plethysmography) establish the same clinical diagnosis of AHR in horses, using histamine bronchoprovocation. Nineteen horses (3-25 years, 335-650 kg) with clinical signs suggestive of mild/moderate equine asthma were enrolled. FOM and FP testing was performed in each horse on two consecutive days, using a randomized cross-over design. AHR was defined by the histamine dose needed to double FOM baseline resistance, or to achieve a 35% increase in FP delta flow. Bronchoalveolar lavage fluid (BALF) was subsequently collected and stained with modified Wright's and toluidine blue stains. Binary statistical tests (related samples T-test, Mann-Whitney U, Chi-square analyses) were performed to compare study groups, with P < 0.05 considered significant. Abnormal BALF cytology confirmed EA in 14/19 (73.7%) horses. Both FOM and FP revealed AHR in 7/14 (50%) of these EA horses. An additional 4/19 (21.1%) horses showed AHR based on FP but not FOM, including two horses with normal BALF cytology. A diagnosis of AHR was more often associated with FP than FOM (P = 0.013), although the prevalence of AHR was significantly higher in EA vs. non-EA horses, regardless of testing methodology. The phase angle between thoracic and abdominal components of breathing did not differ between test groups. In conclusion, FP diagnosed AHR more frequently than did FOM, including horses with no other diagnostic evidence of EA. Without further evaluation, these two testing modalities of AHR cannot be used interchangeably.
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Affiliation(s)
- Claire E Dixon
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States
| | - Daniela Bedenice
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States
| | - Melissa R Mazan
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States
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17
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Couetil L, Cardwell JM, Leguillette R, Mazan M, Richard E, Bienzle D, Bullone M, Gerber V, Ivester K, Lavoie JP, Martin J, Moran G, Niedźwiedź A, Pusterla N, Swiderski C. Equine Asthma: Current Understanding and Future Directions. Front Vet Sci 2020; 7:450. [PMID: 32903600 PMCID: PMC7438831 DOI: 10.3389/fvets.2020.00450] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/19/2020] [Indexed: 12/12/2022] Open
Abstract
The 2019 Havemeyer Workshop brought together researchers and clinicians to discuss the latest information on Equine Asthma and provide future research directions. Current clinical and molecular asthma phenotypes and endotypes in humans were discussed and compared to asthma phenotypes in horses. The role of infectious and non-infectious causes of equine asthma, genetic factors and proposed disease pathophysiology were reviewed. Diagnostic limitations were evident by the limited number of tests and biomarkers available to field practitioners. The participants emphasized the need for more accessible, standardized diagnostics that would help identify specific phenotypes and endotypes in order to create more targeted treatments or management strategies. One important outcome of the workshop was the creation of the Equine Asthma Group that will facilitate communication between veterinary practice and research communities through published and easily accessible guidelines and foster research collaboration.
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Affiliation(s)
- Laurent Couetil
- College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Jacqueline M Cardwell
- Department of Pathobiology and Population Sciences, Royal Veterinary College, London, United Kingdom
| | - Renaud Leguillette
- College of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Melissa Mazan
- Cummings School of Veterinary Medicine, Tufts University, Grafton, MA, United States
| | - Eric Richard
- LABÉO (Frank Duncombe), Normandie Université, UniCaen, Caen, France
| | - Dorothee Bienzle
- Department of Pathobiology, University of Guelph, Guelph, ON, Canada
| | - Michela Bullone
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Vinzenz Gerber
- Vetsuisse Faculty, Institut Suisse de Médecine Équine (ISME), University of Bern and Agroscope, Bern, Switzerland
| | - Kathleen Ivester
- College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Jean-Pierre Lavoie
- Faculty of Veterinary Medicine, University of Montreal, Montreal, QC, Canada
| | - James Martin
- Meakins Christie Laboratories, McGill University Health Center Research Institute, Montreal, QC, Canada
| | - Gabriel Moran
- Department of Pharmacology, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - Artur Niedźwiedź
- Department of Internal Diseases With Clinic for Horses, Dogs and Cats, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
| | - Nicola Pusterla
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Cyprianna Swiderski
- College of Veterinary Medicine, Mississippi State University, Starkville, MS, United States
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18
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Brosnahan MM. Eosinophils of the horse: Part II: Eosinophils in clinical diseases. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M. M. Brosnahan
- College of Veterinary Medicine Midwestern University Glendale Arizona USA
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19
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Hansen S, Klintoe K, Austevoll M, Baptiste KE, Fjeldborg J. Equine airway inflammation in loose-housing management compared with pasture and conventional stabling. Vet Rec 2019; 184:590. [DOI: 10.1136/vr.104580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/25/2018] [Accepted: 02/01/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Sanni Hansen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences; University of Copenhagen; Taastrup Denmark
| | - Kasper Klintoe
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences; University of Copenhagen; Taastrup Denmark
- Danish Veterinary and Food Administration; Stationsparken Denmark
| | | | - Keith E Baptiste
- Department of Veterinary Medicine; Danish Medicines Agency; Copenhagen South Denmark
| | - Julie Fjeldborg
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences; University of Copenhagen; Taastrup Denmark
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20
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Davis KU, Sheats MK. Bronchoalveolar Lavage Cytology Characteristics and Seasonal Changes in a Herd of Pastured Teaching Horses. Front Vet Sci 2019; 6:74. [PMID: 30923711 PMCID: PMC6426765 DOI: 10.3389/fvets.2019.00074] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/21/2019] [Indexed: 01/09/2023] Open
Abstract
Equine asthma syndrome (EAS) is a common problem that affects horses of any age. Severe EAS is reported to affect 10-20% of adult horses in the northern hemisphere, while mild/moderate EAS is reported to affect 60-100% of adult horses, depending on the population and geographic region. For both severe and mild/moderate EAS, the presence of lower airway inflammation is attributed to airborne "triggers" such as dust, mold, and bacterial components that horses encounter in hay and stable-environments; and treatment recommendations for horses with EAS often include full-time pasture turnout. The caveat to this recommendation is horses with summer-pasture associated EAS (SP-EAS), who experience allergic lower airway inflammation when exposed to summer pasture. The prevalence of EAS in horses on pasture that do not have SP-EAS has not been reported. The purpose of this study was to use bronchoalveolar lavage (BAL) cytology to determine the prevalence of EAS in a herd of pastured, adult research horses with no history of respiratory disease. The horses were members of a teaching animal herd housed on pasture in the southeastern United States and fed round-bale Bermuda-grass hay. BAL fluid (BALF) cytology was analyzed in both summer (May-August 2017) and winter (November 2017-February 2018). Similar to previous reports, the prevalence of severe EAS in our study population was 10% in summer and 4.3% in winter. The prevalence of mild/moderate EAS was 60% in summer and 87% in winter. The high prevalence of mild/moderate EAS in this population was unexpected, given the 24-h, year-round pasture environment and the lack of history of respiratory disease. Additionally, 61.1% of horses with both summer and winter data had a different BALF cytology profile between the two seasons. To the authors' knowledge, this is the first study to use BAL cytology to diagnose, and monitor changes in, EAS phenotype in pastured adult horses. These results help to inform discussions regarding prevalence of EAS in pastured, adult horses in the southeastern region of North America.
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Affiliation(s)
- Kaori Uchiumi Davis
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
| | - Mary Katherine Sheats
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
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21
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Tanquerel L, Fillion-Bertrand G, Lavoie JP, Leclere M. Effects of magnesium sulfate infusion on clinical signs and lung function of horses with severe asthma. Am J Vet Res 2018; 79:664-673. [PMID: 30085859 DOI: 10.2460/ajvr.79.6.664] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate whether MgSO4 solution administered IV would improve the clinical signs and lung function of horses with severe asthma and potentiate the effects of salbutamol inhalation in those horses. ANIMALS 6 adult horses with severe asthma. PROCEDURES Asthmatic horses were used in 3 crossover design experiments (6 treatments/horse). Clinical scores for nasal flaring and the abdominal component associated with breathing and lung function were determined before and after administration of salbutamol (800 μg, by inhalation), MgSO4 solution (2.2 mg/kg/min, IV, over 20 minutes), and combined MgSO4-salbutamol treatment. The data were collected during experimental procedures to assess salbutamol inhalation versus mock inhalation, MgSO4 infusion versus infusion of saline (NaCl) solution (adjusted to the same osmolarity as the MgSO4 solution), and the combined MgSO4-salbutamol treatment versus salbutamol inhalation alone. RESULTS Infusion of MgSO4 significantly improved clinical scores when administered alone or in combination with salbutamol inhalation. With the combination treatment, lung function improved, albeit not significantly. Tidal volume also increased following combined MgSO4-salbutamol treatment. Salbutamol alone significantly improved lung function, whereas saline solution administration and a mock inhalation procedure had no effect on the studied variables. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that MgSO4 infusion alone or in combination with salbutamol inhalation improved the clinical signs of severely asthmatic horses. The effects of MgSO4 were not associated with significant lung function improvement, which suggested that the changes observed were attributable to alterations in the horses' breathing patterns. Infusion of MgSO4 solution at the studied dose offers little advantage over currently used medications for the treatment of severe equine asthma.
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Cullimore AM, Secombe CJ, Lester GD, Robertson ID. Bronchoalveolar lavage fluid cytology and airway hyper-reactivity in clinically normal horses. Aust Vet J 2018; 96:291-296. [PMID: 30129032 DOI: 10.1111/avj.12721] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 02/12/2018] [Accepted: 03/28/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To characterise the relationship between bronchoalveolar lavage fluid (BALF) cytology and pulmonary function testing with histamine bronchoprovocation (HBP) methods in a population of clinically normal horses. DESIGN Cross-sectional study METHODS: Clinically normal adult horses (n = 33) underwent pulmonary function testing and HBP with a commercial flowmetric plethysmography system. BAL was performed 1-5 days later. Statistical analysis was used to assess associations between BALF cell concentration, relative inflammatory cell percentages and categorisation, and airway hyper-reactivity (AHR). RESULTS AHR (PC35 ≤ 8 mg/mL) was demonstrated in 17 (52%) of the horses. Using current definitions, BALF cytology was consistent with inflammatory airway disease in 14 (42%) of the horses and 7 of those demonstrated either mastocytic and/or eosinophilic responses. There was no correlation between total inflammatory cell counts or relative percentage and AHR. No statistical association was found between BALF inflammatory cell categories and AHR. CONCLUSION A direct association between cytological evidence of airway inflammation and AHR was not identified in this population of clinically normal horses. Determining the presence and measuring inflammatory cell mediators in BALF may more accurately reflect AHR. In addition, normal values for cell proportions in BALF may vary between different populations of horses and more appropriate regional reference ranges should be established.
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Affiliation(s)
- A M Cullimore
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - C J Secombe
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - G D Lester
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - I D Robertson
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
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Bond S, Léguillette R, Richard EA, Couetil L, Lavoie JP, Martin JG, Pirie RS. Equine asthma: Integrative biologic relevance of a recently proposed nomenclature. J Vet Intern Med 2018; 32:2088-2098. [PMID: 30294851 PMCID: PMC6271326 DOI: 10.1111/jvim.15302] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/11/2018] [Accepted: 07/24/2018] [Indexed: 12/29/2022] Open
Abstract
The term “equine asthma” has been proposed as a unifying descriptor of inflammatory airway disease (IAD), recurrent airway obstruction (RAO), and summer pasture‐associated obstructive airway disease. Whilst the term will increase comprehensibility for both the lay and scientific communities, its biologic relevance must be compared and contrasted to asthma in human medicine, recognizing the limited availability of peer‐reviewed equine‐derived data, which are largely restricted to clinical signs, measures of airway obstruction and inflammation and response to therapy. Such limitations constrain meaningful comparisons with human asthma phenotypes. Suggested minimum inclusion criteria supporting the term asthma, as well as similarities and differences between IAD, RAO, and multiple human asthma phenotypes are discussed. Furthermore, differences between phenotype and severity are described, and typical features for equine asthma subcategories are proposed. Based on shared features, we conclude that mild/moderate (IAD) and severe (RAO) equine asthma are biologically appropriate models for both allergic and non‐allergic human asthma, with RAO (severe equine asthma) also being an appropriate model for late‐onset asthma. With the development of new biologic treatments in humans and the application of more targeted therapeutic approaches in the horse, it would appear appropriate to further investigate the allergic (Th‐2) and non‐allergic (non‐Th‐2) phenotypes of equine asthma. Further research is required to more fully determine the potential clinical utility of phenotype classification.
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Affiliation(s)
- Stephanie Bond
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta
| | | | - Eric A Richard
- Equine Immunity & Inflammation, LABÉO Frank Duncombe, Caen, France.,BIOTARGEN, Normandie Univ, UniCaen, Biotargen, France
| | - Laurent Couetil
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Quebec
| | - James G Martin
- Meakins Christie Laboratories, McGill University Health Center Research Institute, McGill University, Montreal, Quebec
| | - R Scott Pirie
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, Easter Bush Campus, University of Edinburgh, Midlothian, Scotland, United Kingdom
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Bond SL, Timsit E, Workentine M, Alexander T, Léguillette R. Upper and lower respiratory tract microbiota in horses: bacterial communities associated with health and mild asthma (inflammatory airway disease) and effects of dexamethasone. BMC Microbiol 2017; 17:184. [PMID: 28835202 PMCID: PMC5569571 DOI: 10.1186/s12866-017-1092-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 08/14/2017] [Indexed: 01/04/2023] Open
Abstract
Background The microbial composition of the equine respiratory tract, and differences due to mild equine asthma (also called Inflammatory Airway Disease (IAD)) have not been reported. The primary treatment for control of IAD in horses are corticosteroids. The objectives were to characterize the upper and lower respiratory tract microbiota associated with respiratory health and IAD, and to investigate the effects of dexamethasone on these bacterial communities using high throughput sequencing. Results The respiratory microbiota of horses was dominated by four major phyla, Proteobacteria (43.85%), Actinobacteria (21.63%), Firmicutes (16.82%), and Bacteroidetes (13.24%). Fifty genera had a relative abundance > 0.1%, with Sphingomonas and Pantoea being the most abundant. The upper and lower respiratory tract microbiota differed in healthy horses, with a decrease in richness in the lower airways, and 2 OTUs that differed in abundance. There was a separation between bacterial communities in the lower respiratory tract of healthy and IAD horses; 6 OTUs in the tracheal community had different abundance with disease status, with Streptococcus being increased in IAD horses. Treatment with dexamethasone had an effect on the lower respiratory tract microbiota of both heathy and IAD horses, with 8 OTUs increasing in abundance (including Streptococcus) and 1 OTU decreasing. Conclusions The lower respiratory tract microbiota differed between healthy and IAD horses. Further research on the role of Streptococcus in IAD is warranted. Dexamethasone treatment affected the lower respiratory tract microbiota, which suggests that control of bacterial overgrowth in IAD horses treated with dexamethasone could be part of the treatment strategy. Electronic supplementary material The online version of this article (doi:10.1186/s12866-017-1092-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephanie L Bond
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Edouard Timsit
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
| | - Matthew Workentine
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Trevor Alexander
- Lethbridge Research Centre, Agriculture and Agri-Food Canada, Lethbridge, AB, Canada
| | - Renaud Léguillette
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
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Bullone M, Hélie P, Joubert P, Lavoie JP. Development of a Semiquantitative Histological Score for the Diagnosis of Heaves Using Endobronchial Biopsy Specimens in Horses. J Vet Intern Med 2016; 30:1739-1746. [PMID: 27527123 PMCID: PMC5032871 DOI: 10.1111/jvim.14556] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 06/03/2016] [Accepted: 07/06/2016] [Indexed: 12/11/2022] Open
Abstract
Background Remodeling of the peripheral airways persists during the asymptomatic phase of heaves. Assessing the histology of large bronchi could facilitate the diagnosis of heaves during remission of the disease. Hypothesis Airway inflammation and remodeling in endobronchial biopsy (EBB) specimens differentiate horses with heaves from controls, independently of their clinical status (exacerbation or remission). Animals Fourteen healthy horses and 24 horses with heaves. Methods A 14‐point scoring system assessing central bronchial wall inflammation and remodeling was developed. The score was validated by 2 pathologists using specimens obtained from 18 horses (6 controls, 6 with heaves exacerbation, and 6 with heaves remission) in which lung function had been assessed with impulse oscillometry. Clinical and research application of the score was evaluated using biopsy specimens obtained from 20 additional horses (8 controls, 6 with heaves exacerbation, and 6 with heaves remission). Results The score was repeatable (interclass correlation coefficient = 69%). It differentiated horses with heaves in exacerbation (mean ± SD: 6.2 ± 2.2) from those in remission (4.0 ± 1.0) and controls (3.6 ± 1.7, P < 0.0001). The histological scores of horses with heaves correlated with the ratio of respiratory resistance (R) at 5 and 10 Hz (R5 : R10 ratio, r = 0.65, P = 0.03), a parameter assessing airway obstruction. Conclusions and Clinical Significance The proposed histological scoring system correlates with the degree of airway obstruction measured by impulse oscillometry. However, it does not discriminate horses with heaves in remission from controls. Evaluation of EBB specimens might be considered in future research and clinical studies of respiratory diseases in horses.
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Affiliation(s)
- M Bullone
- Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada
| | - P Hélie
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, QC, Canada
| | - P Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, QC, Canada
| | - J-P Lavoie
- Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada.
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Couëtil LL, Cardwell JM, Gerber V, Lavoie JP, Léguillette R, Richard EA. Inflammatory Airway Disease of Horses--Revised Consensus Statement. J Vet Intern Med 2016; 30:503-15. [PMID: 26806374 PMCID: PMC4913592 DOI: 10.1111/jvim.13824] [Citation(s) in RCA: 252] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/07/2015] [Accepted: 12/07/2015] [Indexed: 01/08/2023] Open
Abstract
The purpose of this manuscript is to revise and update the previous consensus statement on inflammatory airway disease (IAD) in horses. Since 2007, a large number of scientific articles have been published on the topic and these new findings have led to a significant evolution of our understanding of IAD.
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Affiliation(s)
- L L Couëtil
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN
| | - J M Cardwell
- Department of Production and Population Health, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - V Gerber
- Swiss Institute of Equine Medicine, University of Berne and Agroscope, Berne, Switzerland
| | - J-P Lavoie
- Faculté de Médicine Vétérinaire, Département de Sciences Cliniques, Université de Montreal, St-Hyacinthe, Québec, Canada
| | - R Léguillette
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - E A Richard
- Normandie Université, UNICAEN, Caen Cedex 4, France
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Mazan MR. Update on noninfectious inflammatory diseases of the lower airway. Vet Clin North Am Equine Pract 2015; 31:159-85. [PMID: 25770068 DOI: 10.1016/j.cveq.2014.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Inflammatory airway disease and recurrent airway obstruction are 2 nonseptic diseases of the equine respiratory system with a shared cause of exposure to particulate matter. They appear to occupy 2 ends of a spectrum of disease, but are differentiated by history, clinical signs, and response to treatment. Diagnosis can be made by sampling of respiratory fluids and lung function testing. Treatment consists of environmental modification and pharmacologic treatment with systemic or inhaled corticosteroids and bronchodilators.
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Affiliation(s)
- Melissa R Mazan
- Large Animal Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westborough Road, North Grafton, MA 01536, USA.
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Secombe CJ, Lester GD, Robertson ID, Cullimore AM. Retrospective survey of bronchoalveolar lavage fluid cytology in Western Australian horses presented for evaluation of the respiratory tract: effect of season on relative cell percentages. Aust Vet J 2015; 93:152-6. [DOI: 10.1111/avj.12315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 07/02/2014] [Accepted: 07/11/2014] [Indexed: 10/23/2022]
Affiliation(s)
- CJ Secombe
- College of Veterinary Medicine; Murdoch University; South Street Murdoch Western Australia, WA 6150 Australia
| | - GD Lester
- College of Veterinary Medicine; Murdoch University; South Street Murdoch Western Australia, WA 6150 Australia
| | - ID Robertson
- College of Veterinary Medicine; Murdoch University; South Street Murdoch Western Australia, WA 6150 Australia
| | - AM Cullimore
- College of Veterinary Medicine; Murdoch University; South Street Murdoch Western Australia, WA 6150 Australia
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Richard EA, Depecker M, Defontis M, Leleu C, Fortier G, Pitel PH, Couroucé-Malblanc A. Cytokine concentrations in bronchoalveolar lavage fluid from horses with neutrophilic inflammatory airway disease. J Vet Intern Med 2014; 28:1838-44. [PMID: 25269933 PMCID: PMC4895612 DOI: 10.1111/jvim.12464] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 05/20/2014] [Accepted: 08/25/2014] [Indexed: 11/29/2022] Open
Abstract
Background Multiple cytological patterns occur in bronchoalveolar lavage fluid (BALF) of horses with inflammatory airway disease (IAD). Only few data on BALF cytokine profiles are available for horses with IAD, and are limited to mRNA expression. Hypothesis/Objective Cytological profiles of IAD are associated with different BALF immunological pathways. To investigate BALF cytokine concentrations in a large number of horses with neutrophilic IAD. Animals One hundred and thirty‐eight client‐owned Standardbred racehorses in active training. Methods Prospective observational study. BALF samples were obtained from left and right lungs. Interleukin (IL)‐4, interferon (IFN)‐γ, and tumor necrosis factor (TNF)‐α concentrations were determined by ELISA. Results Fourteen horses had normal BALF cytological profiles and 56 exhibited evidence of bilateral neutrophilic IAD. Twenty‐four horses showed BALF with, respectively, IAD‐ and CTL consistent cytology and were excluded; as were 44 horses because of evidence of pulmonary hemorrhage. TNF‐α (56 ± 115 pg/mL; P = .034) and IFN‐γ concentrations (104 ± 247 pg/mL; P = .044) were significantly higher for IAD horses, compared with controls (respectively 19 ± 41 and 80 ± 116 pg/mL). Horses with ‘neutrophil’ subtype had significantly higher IFN‐γ concentrations (110 ± 154 pg/mL), than ‘neutrophil/metachromatic’ (56 ± 54 pg/mL; P = .028) and ‘neutrophil/metachromatic/eosinophil’ subtypes (44 ± 23 pg/mL; P = .012). Conclusions and Clinical Importance Cytokine concentrations in BALF suggested that neutrophilic IAD is associated with activation of the innate immune system and a possible T‐helper (Th)‐1 polarized response. This study also suggested that immunological pathways vary according to cytological IAD subtypes.
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Affiliation(s)
- E A Richard
- Normandie Université, UNICAEN, SF 4206 ICORE/LABÉO Frank Duncombe, 14053, Caen Cedex 4, France
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Bullone M, Chevigny M, Allano M, Martin JG, Lavoie JP. Technical and physiological determinants of airway smooth muscle mass in endobronchial biopsy samples of asthmatic horses. J Appl Physiol (1985) 2014; 117:806-15. [PMID: 25103978 DOI: 10.1152/japplphysiol.00468.2014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Morphometric analyses of endobronchial biopsies are commonly performed in asthma research but little is known about the technical and physiological parameters contributing to measurement variability. We investigated factors potentially affecting biopsy size, quality, and airway smooth muscle (ASM) content in heaves, an asthma-like disease of horses. Horses with heaves in clinical exacerbation (n = 6) or remission (n = 6) from the disease and six controls were studied using a crossover design. The effect of disease status, age, bronchodilation, biopsy forceps type, and carina size on total biopsy area (Atot), ASM area (AASM), ASM% (AASM/Atot), and histologic quality were assessed. Concordance among different measuring techniques was also assessed. Compared with other groups, horses with heaves in exacerbation yielded larger biopsies (P < 0.05). Better quality biopsies were obtained from carinae of small size compared with large ones (P = 0.02), and carina size and forceps type significantly affected the ASM content of the biopsy (interaction, P < 0.05). AASM increased with age only in heaves-affected horses (r = 0.9, P < 0.05), and ASM% was negatively correlated with pulmonary resistance at 5 Hz in heaves-affected horses (r = -0.74, P = 0.01), likely because of the increased thickness of the extracellular matrix layer in this group (P = 0.01). In conclusion, disease status, carina thickness, and the forceps used may significantly affect biopsy size, quality, and ASM content. Endobronchial biopsies are not appropriate samples for ASM quantification in heaves, and studies measuring ASM mass should not be compared when measuring techniques differ.
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Affiliation(s)
- Michela Bullone
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Québec, Canada; and
| | - Mylène Chevigny
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Québec, Canada; and
| | - Marion Allano
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Québec, Canada; and
| | - James G Martin
- Meakins-Christie Laboratories, Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Québec, Canada; and
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Ivester KM, Couëtil LL, Moore GE, Zimmerman NJ, Raskin RE. Environmental exposures and airway inflammation in young thoroughbred horses. J Vet Intern Med 2014; 28:918-24. [PMID: 24773603 PMCID: PMC4895475 DOI: 10.1111/jvim.12333] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 12/06/2013] [Accepted: 01/21/2014] [Indexed: 01/13/2023] Open
Abstract
Background Inflammatory airway disease (IAD) in horses is a widespread, performance‐limiting syndrome believed to develop in response to inhaled irritants in the barn environment. Objectives To evaluate changes in bronchoalveolar lavage fluid (BALF) cytology and exposure to particulates, endotoxin, and ammonia during horses' first month in training. Animals Forty‐nine client‐owned 12‐ to 36‐month‐old Thoroughbred horses entering race training. Methods In this prospective cohort study, a convenience sample of horses was assigned to be fed hay from a net (n = 16), whereas the remaining horses were fed hay from the ground (n = 33). BALF was collected at enrollment and after 14 and 28 days in training. Respirable particulate, inhalable particulate, respirable endotoxin, and ammonia concentrations were measured at the breathing zone of each horse weekly. Results Median respirable particulates were significantly higher when horses were fed from hay nets than when fed hay from the ground (hay net 0.28 mg/m3, no hay net 0.055 mg/m3, P < .001). Likewise, inhalable particulate (hay net 8.3 mg/m3, no hay net 3.3 mg/m3, P = .0064) and respirable endotoxin (hay net 173.4 EU/m3, no hay net 59.2 EU/m3, P = .018) exposures were significantly higher when horses were fed from hay nets. Feeding hay from a net resulted in significantly higher BALF eosinophil proportions over time (P < .001). BALF eosinophils were significantly related to respirable particulate exposure (14 days in training rs = 0.37, P = .012, 28 days in training, rs = 0.38, P = .017). Conclusions and Clinical Importance Pulmonary eosinophilic inflammation develops in response to respirable particulate exposure in young Thoroughbreds, indicating a potential hypersensitivity to inhaled particulate allergens.
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Affiliation(s)
- K M Ivester
- Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN
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Depecker M, Richard EA, Pitel PH, Fortier G, Leleu C, Couroucé-Malblanc A. Bronchoalveolar lavage fluid in Standardbred racehorses: Influence of unilateral/bilateral profiles and cut-off values on lower airway disease diagnosis. Vet J 2014; 199:150-6. [DOI: 10.1016/j.tvjl.2013.10.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 01/30/2023]
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Nolen-Walston RD, Harris M, Agnew ME, Martin BB, Reef VB, Boston RC, Davidson EJ. Clinical and diagnostic features of inflammatory airway disease subtypes in horses examined because of poor performance: 98 cases (2004–2010). J Am Vet Med Assoc 2013; 242:1138-45. [DOI: 10.2460/javma.242.8.1138] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Van Erck-Westergren E, Franklin SH, Bayly WM. Respiratory diseases and their effects on respiratory function and exercise capacity. Equine Vet J 2013; 45:376-87. [PMID: 23368813 DOI: 10.1111/evj.12028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 12/02/2012] [Indexed: 12/26/2022]
Abstract
Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes.
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Daily variability of forced oscillometry parameters in horses suffering recurrent airway obstruction, a pilot study. Vet Res Commun 2012; 37:11-7. [DOI: 10.1007/s11259-012-9541-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2012] [Indexed: 10/27/2022]
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Abstract
Animal models have been developed to investigate specific components of asthmatic airway inflammation, hyper-responsiveness or remodelling. However, all of these aspects are rarely observed in the same animal. Heaves is a naturally occurring disease of horses that combines these features. It is characterized by stable dust-induced inflammation, bronchospasm and remodelling. The evaluation of horses during well-controlled natural antigen exposure and avoidance in experimental settings allows the study of disease mechanisms in the asymptomatic and symptomatic stages, an approach rarely feasible in humans. Also, the disease can be followed over several years to observe the cumulative effect of repeated episodes of clinical exacerbation or to evaluate long-term treatment, contrasting most murine asthma models. This model has shown complex gene and environment interactions, the involvement of both innate and adaptive responses to inflammation, and the contribution of bronchospasm and tissue remodelling to airway obstruction, all occurring in a natural setting. Similarities with the human asthmatic airways are well described and the model is currently being used to evaluate airway remodelling and its reversibility in ways that are not possible in people for ethical reasons. Tools including antibodies, recombinant proteins or gene arrays, as well as methods for sampling tissues and assessing lung function in the horse are constantly evolving to facilitate the study of this animal model. Research perspectives that can be relevant to asthma include the role of neutrophils in airway inflammation and their response to corticosteroids, systemic response to pulmonary inflammation, and maintaining athletic capacities with early intervention.
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Affiliation(s)
- Mathilde Leclere
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Canada
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VAN ERCK E. Dynamic respiratory videoendoscopy in ridden sport horses: Effect of head flexion, riding and airway inflammation in 129 cases. Equine Vet J 2011:18-24. [DOI: 10.1111/j.2042-3306.2011.00492.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Richard EA, Pitel PH, Christmann U, Lekeux P, Fortier G, Pronost S. Serum concentration of surfactant protein D in horses with lower airway inflammation. Equine Vet J 2011; 44:277-81. [PMID: 21696440 DOI: 10.1111/j.2042-3306.2011.00421.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
REASONS FOR PERFORMING STUDY Surfactant protein D (SP-D), mainly synthesised by alveolar type II cells and nonciliated bronchiolar cells, is one important component of innate pulmonary immunity. In man, circulating concentrations of SP-D are routinely used as biomarkers for pulmonary injury. To date, serum SP-D levels have only been investigated in horses in an experimental model of bacterial airway infection. OBJECTIVES To compare serum SP-D concentrations at rest and after exercise in horses with and without inflammatory airway disease (IAD). METHODS Venous blood samples were collected from 42 Standardbred racehorses at rest and 60 min after performing a standardised treadmill exercise test. Tracheal wash and bronchoalveolar lavage fluid (BALF) samples were collected after exercise. Based on BALF cytology, 22 horses were defined as IAD-affected and 20 classified as controls. Serum SP-D concentrations were assessed using a commercially available ELISA kit and statistically compared between groups of horses and sampling times. RESULTS Serum concentrations of SP-D in IAD-affected horses were significantly higher than those of control horses, both at rest and after exercise. Within the IAD-affected group, no significant correlation was found between serum SP-D concentrations and BALF cytology. Within each group of horses (IAD and control), no significant influence of exercise was found on serum SP-D levels. CONCLUSIONS This is the first study determining serum SP-D concentrations in a noninfectious, naturally occurring form of lower airway inflammation in horses. The results highlight that IAD is associated with a detectable, though moderate, increase of circulating SP-D levels. POTENTIAL RELEVANCE Serum concentration of surfactant protein D could represent a potentially valuable and readily accessible blood biomarker of equine lower airway inflammation.
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Affiliation(s)
- E A Richard
- Frank Duncombe Laboratory, Route de Rosel, Caen Cedex, France.
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Lavoie J, Cesarini C, Lavoie-Lamoureux A, Moran K, Lutz S, Picandet V, Jean D, Marcoux M. Bronchoalveolar Lavage Fluid Cytology and Cytokine Messenger Ribonucleic Acid Expression of Racehorses with Exercise Intolerance and Lower Airway Inflammation. J Vet Intern Med 2011; 25:322-9. [DOI: 10.1111/j.1939-1676.2010.0664.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Laboratory findings in respiratory fluids of the poorly-performing horse. Vet J 2010; 185:115-22. [PMID: 19481964 DOI: 10.1016/j.tvjl.2009.05.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Revised: 04/30/2009] [Accepted: 05/03/2009] [Indexed: 11/23/2022]
Abstract
Any disorder impairing a performance horse's ability to ventilate its lungs and exchange oxygen compromises exercise performance in any discipline. Since bronchoalveolar lavage was described in horses in the early 1980s, laboratory evaluation of respiratory fluids, along with clinical and functional assessment of the respiratory system, has become a relevant step in the diagnosis of respiratory disease affecting performance. The aim of this review is to provide objective information to assist clinicians in interpreting laboratory findings by (1) summarising published cytological references values in both clinically healthy horses and those with various airway diseases, (2) assessing the influence of physiological circumstances, such as exercise, on the cytological evaluation, (3) discussing the relationship between cytological and microbiological analyses, clinical signs and respiratory function, and (4) suggesting how this latter relationship may affect performance.
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Richard EA, Fortier GD, Pitel PH, Dupuis MC, Valette JP, Art T, Denoix JM, Lekeux PM, Erck EV. Sub-clinical diseases affecting performance in Standardbred trotters: Diagnostic methods and predictive parameters. Vet J 2010; 184:282-9. [DOI: 10.1016/j.tvjl.2009.04.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 04/14/2009] [Accepted: 04/15/2009] [Indexed: 10/20/2022]
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The racehorse and the dairy cow: A question of productivity. Vet J 2010; 184:251-2. [DOI: 10.1016/j.tvjl.2009.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Accepted: 06/26/2009] [Indexed: 11/20/2022]
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