Cytokine and Chemokine Profiling in Cats With Sepsis and Septic Shock

What we know about alterations in immune cells during sepsis in veterinary animals?

Sepsis is still one of the most common causes of death of animals and humans. It is marked by an aberrant immune response to infection, resulting in extensive inflammation, organ dysfunction, and, in severe instances, organ failure. Recognizable symptoms and markers of sepsis encompass substantial elevations in body temperature, respiratory rate, hemoglobin levels, and alterations in immune cell counts, including neutrophils, monocytes, and basophils, along with increases in certain acute-phase proteins. In contrast to human medicine, veterinarians must take into account some species differences. This article provides a comprehensive overview of changes in the immune system during sepsis, placing particular emphasis on species variations and exploring potential future drugs and interventions. Hence, understanding the intricate balance of the immune responses during sepsis is crucial to develop effective treatments and interventions to improve the chances of recovery in animals suffering from this serious condition.

Regulatory effect of Pseudomonas aeruginosa mannose-sensitive hemagglutinin on inflammation and immune function in percutaneous nephrolithotomy patients with upper urinary tract calculi complicated with infection

Objective

To study the effect of an injection of Pseudomonas aeruginosa mannose-sensitive hemagglutinin (PA-MSHA) on inflammation and immune function in patients with upper urinary tract calculi complicated by infection who have undergone percutaneous nephrolithotomy.

Methods

We retrospectively recorded the clinical data of patients with upper urinary tract calculi complicated by infection who have undergone Percutaneous nephrolithotomy(PCNL) in the Department of Urology, 2nd Affiliation Hospital of Kunming Medical University, from March to December 2021. Clinical data include general condition, laboratory index, CT, postoperative body temperature, heart rate, respiration, SIRS, sepsis, etc. Patients were divided into treated and control groups according to whether they had received a preoperative PA-MSHA injection. The two groups were compared for indices of inflammation and complications of infection after PCNL. Pre- and post-operative lymphocyte subsets and immunoglobulin changes were compared.

Results

115 patients were included in the study, including 43 in the treatment group and 72 in the control group. After Propensity Score Matching, 90 patients were divided into treatment (n=35) and control (n=55) groups. The postoperative inflammation index was higher in the treatment group than in the control group (P<0.05). The incidence of postoperative SIRS was higher in the treatment group than control (P<0.05). There were no cases of sepsis in either group. The double-positive T cells lymphocyte subsets were higher in the treatment group than in the control group ((P<0.05). Pre- and post-operative changes in immune function: total T lymphocyte count reduced, NK and NKT cell count increased in the control group, double-positive T cell count increased in the treatment group, IgG, IgA, IgM, complement C3 and C4 count reduced in both groups post-operatively.

Conclusion

This study found that patients with upper urinary tract calculi and infection treated with antibiotic-based PA-MSHA before percutaneous nephrolithotomy had an increased inflammatory response after surgery, which may play a role in the prevention and treatment of sepsis. The percentage of double-positive T cells in the peripheral blood was increased after PA-MSHA treatment, which may have an immunomodulatory and protective effect in PCNL patients with stones complicated by infection.

Secretory Profile of Adipose-Tissue-Derived Mesenchymal Stem Cells from Cats with Calicivirus-Positive Severe Chronic Gingivostomatitis

The feline calicivirus (FCV) causes infections in cats all over the world and seems to be related to a broad variety of clinical presentations, such as feline chronic gingivostomatitis (FCGS), a severe oral pathology in cats. Although its etiopathogeny is largely unknown, FCV infection is likely to be a main predisposing factor for developing this pathology. During recent years, new strategies for treating FCGS have been proposed, based on the use of mesenchymal stem cells (MSC) and their regenerative and immunomodulatory properties. The main mechanism of action of MSC seems to be paracrine, due to the secretion of many biomolecules with different biological functions (secretome). Currently, several pathologies in humans have been shown to be related to functional alterations of the patient’s MSCs. However, the possible roles that altered MSCs might have in different diseases, including virus-mediated diseases, remain unknown. We have recently demonstrated that the exosomes produced by the adipose-tissue-derived MSCs (fAd-MSCs) from cats suffering from FCV-positive severe and refractory FCGS showed altered protein contents. Based on these findings, the goal of this work was to analyze the proteomic profile of the secretome produced by feline adipose-tissue-derived MSCs (fAd-MSCs) from FCV-positive patients with FCGS, in order to identify differences between them and to increase our knowledge of the etiopathogenesis of this disease. We used high-resolution mass spectrometry and functional enrichment analysis with Gene Ontology to compare the secretomes produced by the fAd-MSCs of healthy and calicivirus-positive FCGS cats. We found that the fAd-MSCs from cats with FCGS had an increased expression of pro-inflammatory cytokines and an altered proteomic profile compared to the secretome produced by cells from healthy cats. These findings help us gain insight on the roles of MSCs and their possible relation to FCGS, and may be useful for selecting specific biomarkers and for identifying new therapeutic targets.

Classification of Septic Shock Phenotypes Based on the Presence of Hypotension and Hyperlactatemia in Cats

Background: Three different phenotypes of septic shock based on changes in blood pressure and lactate are recognized in people. Dysoxic shock, representing the combination of fluid-refractory hypotension and hyperlactatemia, is characterized by greater disease severity and mortality compared to cryptic shock (hyperlactatemia alone) and vasoplegic shock (hypotension with normal blood lactate). Little is known about septic shock and specifically its phenotypes in cats. Objective: To analyze the characteristics and prognostic implications of three septic shock phenotypes in cats with sepsis. Methods: Cats with septic shock were prospectively included. Septic shock was defined by the presence of hypotension (mean blood pressure <60 mmHg) requiring vasopressor support and/or persistent hyperlactatemia (>4 mmol/L) and classified in three subgroups: dysoxic shock, vasoplegic shock and cryptic shock. Clinical and clinicopathological variables including APPLE_fast and APPLE_full scores, occurrence of multi-organ dysfunction syndrome (MODS; presence of at least two dysfunctional organs simultaneously) and outcome were compared among subgroups. Cats with sepsis showing normal blood pressure and lactate concentrations hospitalized during the study period were included as uncomplicated sepsis, and compared to cats with septic shock for selected variables. Length of hospital stay and mortality were evaluated in the whole study population. Odds ratios for mortality were calculated using logistic regression analysis. Significance was set at P < 0.05. Results: The study enrolled 48 cats with uncomplicated sepsis and 37 cats with septic shock (dysoxic shock n = 17; vasoplegic shock n = 11; cryptic shock n = 7). Cats with dysoxic shock had significantly higher APPLE_fast and APPLE_full scores compared to vasoplegic and cryptic shock. Mortality rates were not significantly different among cryptic (57%), dysoxic (65%) and vasoplegic shock (91%), while MODS occurrence was significantly lower in cats with cryptic shock (57%) compared to patients affected by dysoxic (94%) and vasoplegic (100%) shock. Cats with septic shock had higher frequency of MODS and greater mortality rate than cats with uncomplicated sepsis. Conclusion: Despite similar in-hospital mortality, cats with dysoxic and vasoplegic shock are characterized by having higher occurrence of multi- organ dysfunction compared to cats affected by cryptic shock. Results from this study suggest novel means of identifying high-risk subgroups of septic cats.

Characterisation of the serum cytokine profile in feline atopic skin syndrome

BACKGROUND

Feline atopic skin syndrome (FASS) is a pruritic and inflammatory skin disease commonly encountered in cats. Three previous reports evaluated cytokine immune activation in cats diagnosed with feline allergic dermatitis. However, no significant upregulations were observed in allergic cats compared to healthy controls.

HYPOTHESIS/OBJECTIVE

To evaluate differences in the serum cytokine profile of cats diagnosed with FASS compared to healthy cats, and correlate serum markers with the extent of FASS skin disease using clinical scoring systems.

ANIMALS

Thirteen client-owned FASS cats and 12 healthy control cats.

METHODS AND MATERIALS

Thirteen cytokine and chemokines from the serum of FASS cats and healthy controls were analysed using a commercially available feline-specific multiplex assay.

RESULTS

Patients with FASS had a significant increase in serum concentrations of interferon-gamma (IFN-γ), interleukin (IL)-2, IL-13 and IL-18. In addition, cytokine/chemokines involved in inflammation and chemotaxis [IL-8, C-C Motif Chemokine Ligand (CCL)5, CCL2 and CXCL12], as well as growth factors, stem cell factor and Fms-related tyrosine kinase 3 ligand (Flt3L), also were significantly elevated. A significant positive correlation (r = 0.64) between the serum levels of Flt3L and Scoring Feline Allergic Dermatitis (SCORFAD) score was observed.

CONCLUSIONS

These results demonstrate the activation of a broad array of immune secretory cytokines in the serum of cats with FASS, which are largely associated with a mixed Th1 and Th2 inflammatory response along with specific growth factors. Further larger-sample studies are needed to assess the modulation of serum biomarkers in FASS by pharmacological/therapeutic interventions.

Leukocytes Ratios in Feline Systemic Inflammatory Response Syndrome and Sepsis: A Retrospective Analysis of 209 Cases

Simple Summary

Feline sepsis is a life-threatening syndrome in which blood diagnostic and prognostic markers are limited. We investigated the differences in neutrophil-to-lymphocyte ratio and other white-blood-cell ratios between healthy and sick cats (systemic inflammation (SIRS) and/or septic cats) and then the use of these ratios as prognostic markers. This study included 76 healthy cats (blood-donors), 54 cats with SIRS and 79 cats with sepsis. A cat with an NLR > 4.53 had a 44-fold chance to have SIRS or sepsis, although only BLR and BNLR were different between SIRS and sepsis groups. The NLR has been shown as a prognostic marker in sick cats. This is a novel investigation about leukocyte ratios in the cat, and the NLR may be used as a prognostic parameter in cats with SIRS or sepsis, and BLR and BNLR demonstrate themselves as promising tools in differentiating SIRS from sepsis.

Abstract

Sepsis is a challenging condition in which hematological prognostic and diagnostic markers in cats are limited. The aims of this study were to test if there are any differences in leukocyte ratios (NLR, BLR and BNLR) between healthy, SIRS and septic cats (sick cats), and if, within sick cats, NLR, BLR and BNLR may be prognostic markers. A retrospective medical database study included 76 healthy cats (blood-donors), 54 SIRS and 79 septic cats. SIRS group was defined if cats fulfilled SIRS criteria. Sepsis was confirmed with an infectious focus on cytology or a positive culture for bacterial infection. Leukocyte ratios were compared among the three study groups and between survivors and non-survivors in sick cats. NLR resulted significantly higher in the sick group compared to healthy cats (p < 0.0001), although NLR was not different between SIRS and sepsis. An NLR > 4.53 had a sensitivity of 76% and a specificity of 93.4% to detect SIRS/sepsis (OR 44.8 95%CI 17–107). Only BLR and BNLR were significantly different between SIRS and sepsis. NLR was associated with mortality in the sick group (p = 0.04). Although NLR resulted higher in sick cats than healthy, BLR and BNLR demonstrated as promising tools in differentiating SIRS from sepsis. NLR was associated with mortality in sick cats.

Botanicals Reduce Circulating Concentrations of Cholesterol and Triglycerides and Work Synergistically With Arachidonic Acid to Reduce Inflammatory Cytokines in Cats

Forty Eight cats were used to measure the effects of feeding a traditional adult cat food supplemented with either arachidonic acid (ARA), a botanical mix (botanicals) or both on circulating biochemical parameters and inflammatory cytokines. The cats were healthy adults (mean age, 3.0; range, 1.3-6.4 years). The adult cats were fed one of four foods (n = 12 per group) for 84 days (dietary changes reported as fed): a traditional adult cat food (control, 0.05% ARA no added botanicals), or control food supplemented with arachidonic acid from chicken liver (0.13% ARA when supplemented), control food supplemented with botanicals (green tea 0.5%, fenugreek 0.05%, and tulsi 0.003%), and control plus ARA (0.13% as fed) with botanicals (green tea 0.5%, fenugreek 0.05%, and tulsi 0.003%). Response variables were compared between treatments: initially, and at 84 days (end of study). The measurements were standard complete blood counts and chemistries as well as circulating cytokines. Botanical inclusion reduced (P < 0.05) circulating cholesterol and triglycerides while arachidonic acid increased (P < 0.05) their concentrations. The pro-inflammatory cytokines MCP-1, TNFα, SDF-1, Flt3L, IL-8, IL-12p40, IL-13, and IL-18 were all reduced (P < 0.05) in cats after consuming the ARA + botanicals food for 84 days with little change after consuming the other foods. Therefore, this combination of ARA and botanicals may be of value in reducing inflammation.