New Pathophysiological Insights from Serum Proteome Profiling in Equine Atypical Myopathy

Equine atypical myopathy (AM) is a severe environmental intoxication linked to the ingestion of protoxins contained in seeds and seedlings of the sycamore maple (Acer pseudoplatanus) in Europe. The toxic metabolites cause a frequently fatal rhabdomyolysis syndrome in grazing horses. Since these toxic metabolites can also be present in cograzing horses, it is still unclear as to why, in a similar environmental context, some horses show signs of AM, whereas others remain clinically healthy. Label-free proteomic analyses on the serum of 26 diseased AM, 23 cograzers, and 11 control horses were performed to provide insights into biological processes and pathways. A total of 43 and 44 differentially abundant proteins between "AM vs cograzing horses" and "AM vs control horses" were found. Disease-linked changes in the proteome of different groups were found to correlate with detected amounts of toxins, and principal component analyses were performed to identify the 29 proteins representing a robust AM signature. Among the pathway-specific changes, the glycolysis/gluconeogenesis pathway, the coagulation/complement cascade, and the biosynthesis of amino acids were affected. Sycamore maple poisoning results in a combination of inflammation, oxidative stress, and impaired lipid metabolism, which is trying to be counteracted by enhanced glycolysis.

Airway Hyperresponsiveness, but Not Bronchoalveolar Inflammatory Cytokines Profiles, Is Modified at the Subclinical Onset of Severe Equine Asthma

Airway hyperresponsiveness (AHR) and inflammation are both observed in human and equine asthma. The aim of this study was to assess the timeline and relationship of both features at the subclinical onset of severe equine asthma (SEA). First, the repeatability of the pulmonary function test (PFT) using impulse oscillometry system, and the methacholine bronchoprovocation test (BPT) were assessed at a 1-day interval on six SEA horses in clinical remission and six control horses. Then, clinical and ancillary tests were performed before and after a 1-week low-dust environmental challenge, including weighted clinical score, respiratory endoscopy, bronchoalveolar fluid cytology, PFT, and BPT. Both PFT and BPT showed acceptable repeatability. No test allowed SEA horses in clinical remission to be distinguished from control, unlike in human patients. Because of the low-dust environment, no significant difference was observed in the results of clinical and conventional ancillary examinations after the challenge. However, SEA horses showed increased AHR after the environmental challenge. At that stage, no signs of inflammation or changes in pro-inflammatory cytokines profiles (quantification and gene expression) were observed, suggesting AHR is present at an earlier stage of equine asthma than airway inflammation. This feature indicates SEA could present in a different disease pathway than neutrophilic human asthma.

In vitro virucidal activity of nebulized citrate-complexed silver nanoparticles against equine herpesvirus-1 and murine norovirus

Viruses can be involved in respiratory disorders in horses, with limited therapeutic options. Citrate-complexed silver nanoparticles (C-AgNP) have shown bactericidal properties after in vitro nebulization. The aim of the present study was to assess the virucidal activity of C-AgNP after in vitro instillation or nebulization on equine herpesvirus-1 (EHV-1) and murine norovirus (MNV), the latter used as surrogate for small non-enveloped viruses. Both viruses were instilled or nebulized with C-AgNP of increasing concentrations, and titres were determined via TCID₅₀ method. We demonstrated efficient inactivation of enveloped EHV-1 following instillation and nebulization of C-AgNP (infectivity losses of ≥ three orders of magnitude). While tenacious MNV was inactivated via 2000 ppm C-AgNP instillation, nebulized C-AgNP did not lead to reduction in MNV titres. Nebulization of C-AgNP may represent a novel virucidal therapeutic approach in horses. Further investigations are needed to assess its safety and effective concentrations for in vivo use.

Accuracy of a heart rate monitor for calculating heart rate variability parameters in exercising horses

Heart rate is evaluated in exercising horses to monitor the level of fitness to exercise, and it is usually acquired using heart rate monitors (HRM) or telemetric electrocardiograms (ECG). While HRM are commonly available and easy-to-use for horse's owners, ECG is a more expensive equipment requiring user's experience. Interest for heart rate variability (HRV) in horses is increasing for both research and clinical purposes. HRV is usually calculated from interbeat intervals (IBI) obtained by ECG. The aim of this study was to determine the accuracy of an HRM to detect IBI for the calculation of HRV in both resting and exercising horses. Simultaneous ECG and HRM recordings were performed on 13 horses and ponies under normal training conditions for at least 45 minutes. IBI from ECG were corrected using a dedicated software. IBI from HRM were exported without correction. Two HRV-parameters were calculated on both recordings for resting and exercising periods: the standard deviation of R-R intervals (SDRR) and the root mean square of successive differences (RMSSD). Agreement and concordance between the two systems were determined using Bland-Altman plot and Lin's correlation coefficient, respectively. Effects of variables were consequently assessed. For both HRV-parameters during resting and exercising periods, the means of the differences between the two systems were lower than 0.47 ms with a correlation coefficient higher than 0.999. Height, weight and body condition score had no effect on the results. The studied HRM could be of interest as easy-to-use device for obtaining HRV-parameters SDRR and RMSSD in resting and exercising horses.

Acylcarnitine profile in Alaskan sled dogs during submaximal multiday exercise points out metabolic flexibility and liver role in energy metabolism

Alaskan sled dogs develop a particular metabolic strategy during multiday submaximal exercise, allowing them to switch from intra-muscular to extra-muscular energy substrates thus postponing fatigue. Specifically, a progressively increasing stimulus for hepatic glycogenolysis and gluconeogenesis provides glucose for both fueling exercise and replenishing the depleted muscle glycogen. Moreover, recent studies have shown that with continuation of exercise sled dogs increase their insulin-sensitivity and their capacity to transport and oxidize glucose and carbohydrates rather than oxidizing fatty acids. Carnitine and acylcarnitines (AC) play an essential role as metabolic regulators in both fat and glucose metabolism; they serve as biomarkers in different species in both physiologic and pathologic conditions. We assessed the effect of multiday exercise in conditioned sled dogs on plasma short (SC), medium (MC) and long (LC) chain AC by tandem mass spectrometry (MS/MS). Our results show chain-specific modification of AC profiles during the exercise challenge: LCACs maintained a steady increase throughout exercise, some SCACs increased during the last phase of exercise and acetylcarnitine (C2) initially increased before decreasing during the later phase of exercise. We speculated that SCACs kinetics could reflect an increased protein catabolism and C2 pattern could reflect its hepatic uptake for energy-generating purposes to sustain gluconeogenesis. LCACs may be exported by muscle to avoid their accumulation to preserve glucose oxidation and insulin-sensitivity or they could be distributed by liver as energy substrates. These findings, although representing a “snapshot” of blood as a crossing point between different organs, shed further light on sled dogs metabolism that is liver-centric and more carbohydrate-dependent than fat-dependent and during prolonged submaximal exercise.

Evaluation of the Bactericidal Effect of Nebulized Silver Nanoparticles on Common Respiratory Bacteria in Horses- In Vitro Studies

Antimicrobial resistance is increasing in both human and veterinary medicine. Bacteria can be part of the etiology of respiratory disorders in horses. Bactericidal activity of silver has been largely described and silver is currently used in veterinary therapeutic applications such as wound dressings. The aim of this study was to assess the in vitro bactericidal effects of nebulized silver nanoparticles (AgNP) on 2 common equine respiratory bacteria, Streptococcus equi subsp. zooepidemicus and Actinobacillus equuli subsp. equuli. Firstly, antimicrobial susceptibility of AgNP was determined over time by turbidity assessment in liquid broth. Secondly, bacterial growth inhibition was tested after instillation or after nebulization of low (100 ppm) and high (500, 1,000 and 2,000 ppm) concentrations of AgNP on agar plate. Both bacteria were susceptible to AgNP, even at dilution 1:4 for A. equuli and 1:8 for S. zooepidemicus after 8 hours of incubation, and 1:256 for both bacteria after 24 hours of incubation. The bacterial growth was partially inhibited at low concentration and completely inhibited at high concentrations of instilled AgNP. The bacterial growth was completely inhibited after nebulization of low concentrations of AgNP for A. equuli and high concentrations of AgNP for S. zooepidemicus. We concluded nebulized AgNP could be a candidate for innovative therapeutic way against bacterial respiratory disorders in horses. Nevertheless, further investigations are required to assess the in vivo potential and toxicity of nebulized AgNP.

Altered mitochondrial oxidative phosphorylation capacity in horses suffering from polysaccharide storage myopathy

Polysaccharide storage myopathy (PSSM) is a widely described cause of exertional rhabdomyolysis in horses. Mitochondria play a central role in cellular energetics and are involved in human glycogen storage diseases but their role has been overlooked in equine PSSM. We hypothesized that the mitochondrial function is impaired in the myofibers of PSSM-affected horses. Nine horses with a history of recurrent exercise-associated rhabdomyolysis were tested for the glycogen synthase 1 gene (GYS1) mutation: 5 were tested positive (PSSM group) and 4 were tested negative (horses suffering from rhabdomyolysis of unknown origin, RUO group). Microbiopsies were collected from the gluteus medius (gm) and triceps brachii (tb) muscles of PSSM, RUO and healthy controls (HC) horses and used for histological analysis and for assessment of oxidative phosphorylation (OXPHOS) using high-resolution respirometry. The modification of mitochondrial respiration between HC, PSSM and RUO horses varied according to the muscle and to substrates feeding OXPHOS. In particular, compared to HC horses, the gm muscle of PSSM horses showed decreased OXPHOS- and electron transfer (ET)-capacities in presence of glutamate&malate&succinate. RUO horses showed a higher OXPHOS-capacity (with glutamate&malate) and ET-capacity (with glutamate&malate&succinate) in both muscles in comparison to the PSSM group. When expressed as ratios, our results highlighted a higher contribution of the NADH pathway (feeding electrons into Complex I) to maximal OXPHOS or ET-capacity in both rhabdomyolysis groups compared to the HC. Specific modifications in mitochondrial function might contribute to the pathogenesis of PSSM and of other types of exertional rhabdomyolyses.

Effects of a P-class CpG-ODN administered by intramuscular injection on plasma cytokines and on white blood cells of healthy horses

Cytosine-phosphate-guanosine (CpG-ODN) has been described as a potent immunostimulatory agent in different species. No study reported the effect of a P-class CpG when administered systemically in healthy horses. The aim of this study was to evaluate the tolerance and the effect of an intramuscularly administered P-class CpG-ODN on hematology and on plasma cytokines (IFN-α, IL-10, TNF-α, IFN-γ) in 8 healthy horses. Intra-muscular CpG-ODN or placebo (PBS) was administered twice at a 7 days-interval. Groups were inversed after 2 months of washout period. A physical examination, complete blood count (CBC) and plasma cytokine measurements were performed from 2 days before injection up to 21 days after injection. P-class CpG-ODN injection was well tolerated with minor side effects. After the first injection a significant transient drop in circulating total leukocytes, lymphocytes and an increase in monocytes were observed. A transient drop in eosinophils was also noted after each CpG injection. P-class CpG-ODN at a dose of 5 mg did not create major side effects in 7 horses, one horse showed transient pyrexia. A redistribution of white blood cells was observed in horses receiving CpG, but no change in plasma cytokines was observed at the indicated dose, route of administration and sampling times.

The innate immune response of equine bronchial epithelial cells is altered by training

Respiratory diseases, including inflammatory airway disease (IAD), viral and bacterial infections, are common problems in exercising horses. The airway epithelium constitutes a major physical barrier against airborne infections and plays an essential role in the lung innate immune response mainly through toll-like receptor (TLR) activation. The aim of this study was to develop a model for the culture of equine bronchial epithelial cells (EBEC) in vitro and to explore EBEC innate immune responses in trained horses. Bronchial epithelial biopsies were taken from 6 adult horses during lower airway endoscopy. EBEC were grown in vitro by an explant method. The innate immune response of EBEC was evaluated in vitro by treatment with TLR ligands. TLR3 is the most strongly expressed TLR at the mRNA level in EBEC and stimulation of EBEC with Poly(I:C), an analog of viral dsRNA, triggers a strong secretion of IFN-β, TNF-α, IL-6 and CXCL8. We further evaluated the EBEC innate immune response in horses that underwent a 4-month-training program. While training had no effect on TLR mRNA expression in EBEC as well as in bronchial biopsies, it increased the production of IFN-β after stimulation with a TLR3 ligand and decreased the secretion of TNF-α and IL-6 after stimulation with a TLR2 and TLR3 ligand. These findings may be implicated in the increased risk for viral and bacterial infections observed in sport horses. Altogether, we report a successful model for the culture of EBEC that can be applied to the investigation of pathophysiologic conditions in longitudinal studies.

Expression microarray as a tool to identify differentially expressed genes in horses suffering from inflammatory airway disease

BACKGROUND

Inflammatory airway disease (IAD) affects performance and well-being of horses. Diagnosis is primarily reached by bronchoalveolar lavage (BAL) cytology which is invasive and requires sedation.

OBJECTIVES

The purpose of this study was to identify differential gene expression in peripheral blood of horses with IAD using species-specific expression microarrays.

METHODS

Equine gene expression microarrays were used to investigate global mRNA expression in circulating leukocytes from healthy, IAD-affected, and low-performing Standardbred and endurance horses.

RESULTS

Nine genes in Standardbred and 61 genes in endurance horses were significantly differentially regulated (P < .001). These genes were related to inflammation (eg, ALOX15B, PLA2G12B, and PENK), oxidant/antioxidant balance (eg, DUOXA2 and GSTO1-1), and stress (eg, V1aR, GRLF1, Homer-2, and MAOB). All these genes were up-regulated, except down-regulated Homer-2 and MAOB. DUOXA2, ALOX15B, PLA2G12B, MAOB, and GRLF1 expression was further validated by RT-qPCR. An increase in glutathione peroxidase (GPx) activity in heparinized whole blood of IAD-affected Standardbred (P = .0025) and endurance horses (P = .0028) also suggests a deregulation of the oxidant/antioxidant balance. There was good correlation (r = .7354) between BAL neutrophil percentage and whole blood GPx activity in all horses.

CONCLUSIONS

This study showed that circulating blood cell gene expression reflects inflammatory responses in tissues. Whether any of the genes have potential for diagnostic applications in the future remains to be investigated. Although not specific for IAD, whole blood GPx activity appears to be correlated with BAL neutrophil percentage. This finding should be further assessed by testing a larger number of horses.

Assessing fitness in endurance horses

A field test and a standardized treadmill test were used to assess fitness in endurance horses. These tests discriminated horses of different race levels: horses participating in races of 120 km and more showed higher values of VLA4 (velocity at which blood lactate reached 4 mmol/L) and V200 (velocity at which heart rates reached 200 beats per min) than horses of lower race levels.

Subclinical diseases underlying poor performance in endurance horses: diagnostic methods and predictive tests

Thirty-eight endurance horses underwent clinical and ancillary examinations, including haematological and biochemical evaluation, standardised exercise tests both on a treadmill and in the field, Doppler echocardiography, impulse oscillometry, video endoscopy and collection of respiratory fluids. All of the examined poorly performing horses were affected by subclinical diseases, and most of them had multiple concomitant disorders. On the contrary, the well-performing horses were free of any subclinical disease. The most frequently diagnosed diseases were respiratory disorders, followed by musculoskeletal and cardiac problems. Poor performers exhibited lower speeds at blood lactate concentration of 4 mmol/l (VLA4) and at heart rates of 160 (V160) and 200 bpm (V200) on the treadmill and in the field, as well as slower recovery of heart rate.

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

REASONS FOR PERFORMING STUDY

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

OBJECTIVE

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSIONS

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

POTENTIAL RELEVANCE

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

Exercise and pharmacological stress echocardiography in healthy horses

REASONS FOR PERFORMING STUDY

Stress echocardiography could be a useful diagnostic test in horses suspected to suffer from exercise-induced myocardial dysfunction as a cause of exercise intolerance.

OBJECTIVE

To evaluate the effect of treadmill exercise and pharmacological stress test on left ventricular echocardiographic parameters.

METHODS

Echocardiography was performed in 2 groups of 5 healthy horses, either immediately after a near-maximal treadmill exercise (Group EXE) or during a pharmacological challenge (Group DOB) consisting of 35 microg/kg atropine, followed by incremental dobutamine infusion rates of 2-6 microg/kg bwt/min for 5 min duration each, which led to a cumulative dobutamine dose of 100 microg/kg. Left ventricular M-mode parameters were compared at rest and at heart rates of 80, 100, 110, 120 130, and 140 beats/min, within each group.

RESULTS

In 2 horses of Group EXE, echocardiographic measurements were impossible at 140 and 130 beats/min, as their heart rates dropped too fast in the immediate post exercise period. In the remaining 3 horses image quality was not always satisfactory at heart rates of 130 and 140 beats/min. Systolic left ventricular parameters and fractional shortening measured at 130 and 140 beats/min were significantly different from values obtained at lower heart rates. Horses in Group DOB reached expected heart rates of 80 and 100 beats/min, after the administration of atropine and during a dobutamine infusion rate of 2 microg/kg bwt/min, respectively. Heart rates targets of 110, 120, 130, and 140 beats/min were reached at mean (+/- s.d.) dobutamine infusion rates of 2.8 +/- 0.4, 3.2 +/- 0.4, 4.0 +/- 0.7, 5 +/- 0.7 microg/kg bwt/min, respectively. Systolic left ventricular parameters and fractional shortening at heart rates of 110, 120, 130, and 140 beats/min, were significantly different from values obtained at lower heart rates.

CONCLUSION

The pharmacological stress test induced changes in ventricular dimensions at heart rates of 80 to 140 beats/min. Using this test, high quality images can easily be obtained at heart rates of 140 beats/min. Conversely, in post exercise echocardiography, obtaining good quality images at heart rates of 130 and 140 beats/min is difficult, which limits use of the technique in routine clinical settings.

POTENTIAL RELEVANCE

Further studies should demonstrate the potential of pharmacological stress test as a diagnostic tool in horses suffering from exercise-induced myocardial dysfunction.

Validation of a portable equine metabolic measurement system

REASONS FOR PERFORMING STUDY

In equine sports medicine, VO2 has been measured exclusively with stationary systems, in laboratories equipped with a treadmill. Measurement during exercise in field conditions has not previously been reported because of the lack of portable equipment designed for horses.

OBJECTIVES

A commercially available portable metabolic measurement system, based on breath-to-breath gas analysis and flow spirometry, was adapted to the horse's physiology and morphology (Cosmed K4b2 and Equimask) and its validity tested by (1) repeatability of the measures and (2) comparing metabolic data to those obtained by a reference method (RM).

METHODS

To test the reproducibility of the measurements, 5 healthy saddle horses were subjected twice at 2 day intervals to a similar submaximal standardised incremental exercise test on a treadmill. The same horses performed twice at one week interval an incremental treadmill test to fatigue: the oxygen consumption and ventilation were measured once with the K4b2 system and once with the RM. The metabolic and ventilatory data obtained with both systems were compared.

RESULTS

There was a good reproducibility of the metabolic measurements obtained by the K4b2 system at any workload. The VO2 obtained by both systems at any workload was not significantly different. However, the K4b2 expired fraction in CO2 (FETCO2) and carbon dioxide production (VCO2) were significantly lower at high and at maximal workloads. As a consequence, the values of the respiratory exchange ratio were too low and incompatible with normal physiological values.

CONCLUSIONS

The good reproducibility of the metabolic and ventilatory measurements and the fact that the VO2 measurements at any workload were similar to the data obtained with the reference method suggested that this system may be used for comparison of repeated VO2 measurements in practical field conditions.

POTENTIAL RELEVANCE

The K4b2 system could be used to improve knowledge of the energetic cost in different equine sports disciplines and offer the opportunity to undertake performance tests with genuine track conditions, on ridden or harnessed horses, rather than under laboratory conditions.

Measurement of respiratory function by impulse oscillometry in horses

REASONS FOR PERFORMING STUDY

Due to technical implementations and lack of sensitivity, pulmonary function tests are seldom used in clinical practice. Impulse oscillometry (IOS) could represent an alternative method.

OBJECTIVES

To define feasibility, methodology and repeatability of IOS, a forced oscillation technique that measures respiratory resistance (Rrs) and reactance (Xrs) from 5 to 35 Hz during spontaneous breathing, in horses.

METHODS

Using 38 healthy horses, Rrs and Xrs reference values were defined and influence of individual biometrical parameters was investigated. In addition, IOS measurements of 6 horses showing clinical signs of heaves were compared to those of 6 healthy horses.

RESULTS

Airtightness and minimal dead space in the facemask were prerequisites to IOS testing and standardisation of head position was necessary to avoid variations in Rrs due to modified upper airway geometry. In both healthy and diseased animals, measurements were repeatable. In standard-type breeds, the influence of the horse's size on IOS parameters was negligible. An increase in R5Hz greater than 0.10 kPa/l/sec and R5Hz>R10Hz, combined with negative values of Xrs between 5 and 20 Hz, was indicative of heaves crisis.

CONCLUSIONS

IOS is a quick, minimally invasive and informative method for pulmonary function testing in healthy and diseased horses.

POTENTIAL RELEVANCE

IOS is a promising method for routine and/or field respiratory clinical testing in the equine species.

Qualitative and quantitative evaluation of equine respiratory mechanics by impulse oscillometry

REASONS FOR PERFORMING STUDY

The long-established conventional reference technique (CRT) for measuring respiratory mechanics in horses lacks sensitivity and there is a need for further refinement in new technology, such as the impulse oscillometry system (IOS).

OBJECTIVES

To evaluate the potential use of the IOS as a clinical respiratory function test and compare it to the current CRT in horses suffering from common upper and lower airway dysfunctions.

METHODS

Six healthy horses were tested before and after induction of a unilateral nasal obstruction (UNO) or transient left laryngeal hemiplegia (LLH). Six heaves-affected horses were tested in clinical remission and during a heaves crisis, before and after nebulisation of cumulative doses of a bronchodilator therapy (ipratropium bromide; IPB).

RESULTS

As opposed to the CRT, the IOS was able to detect partial upper airway obstruction (UAO) caused by UNO or LLH in resting horses, without differentiating both conditions. Upper airway obstruction caused an upward shift of resistance (R(rs)) from 5 to 35 Hz without altering reactance (X(rs)). As for the CRT, IOS respiratory parameters measured in heaves-affected horses in crisis differed significantly from values measured during remission. The difference in frequency-dependent behaviour of R(rs) and X(rs) allowed discrimination between upper and lower airway obstructions. Bronchodilator treatment induced significant dose-dependent changes in X(rs) at 5 and 10 Hz, from the first dose. Total pulmonary resistance (RL) and R(rs) at 5 Hz were affected from the second dose and displayed similar sensitivity. Although post treatment RL values were comparable to remission, R(rs) and X(rs) remained significantly different, characterising persistent peripheral obstruction.

CONCLUSIONS

The IOS was more sensitive than the CRT in detecting partial UAO in resting horses and persistent post treatment peripheral dysfunction in heaves-affected horses. The IOS is a sensitive test that provides graded quantitative and qualitative information on disease-induced respiratory dysfunctions as well as on treatment efficiency in horses.

POTENTIAL RELEVANCE

The IOS could represent a practical and sensitive alternative respiratory function test for routine clinical investigations of common airway obstructive diseases and therapy in horses.

Influence of subclinical inflammatory airway disease on equine respiratory function evaluated by impulse oscillometry

REASONS FOR PERFORMING STUDY

Inflammatory airway disease (IAD) is a nonseptic condition of the lower respiratory tract. Its negative impact on respiratory function has previously been described using either forced expiration or forced oscillations techniques. However, sedation or drug-induced bronchoconstriction were usually required. The impulse oscillometry system (IOS) is a noninvasive and sensitive respiratory function test validated in horses, which could be useful to evaluate IAD-affected horses without further procedures.

OBJECTIVES

To determine the sensitivity of IOS in detecting alterations of the respiratory function in subclinically IAD-affected horses without inducing bronchoprovocation and to characterise their respiratory impedance according to frequency for each respiratory phase.

METHODS

Pulmonary function was evaluated at rest by IOS in 34 Standardbred trotters. According to the cytology of bronchoalveolar lavage fluid (BALF), 19 horses were defined as IAD-affected and 15 horses were used as control (CTL). Total respiratory resistance (Rrs) and reactance (Xrs) from 1-20 Hz as well as their inspiratory and expiratory components were compared between groups.

RESULTS

A significant increase of Rrs at the lower frequencies (R1-10 Hz) as well as a significant decrease of Xrs beyond 5 Hz (X5-20 Hz) was observed in IAD compared to CTL horses. IOS-data was also significantly different between inspiration and expiration in IAD-affected horses. In the whole population, both BALF eosinophil and mast cell counts were significantly correlated with IOS measurements.

CONCLUSIONS

Functional respiratory impairment may be measured, even in the absence of clinical signs of disease. In IAD-affected horses, the different parameters of respiratory function (Rrs or Xrs) may vary depending on the inflammatory cell profiles represented in BALF.

POTENTIAL RELEVANCE

Impulse oscillometry could be used in a routine clinical setting as a noninvasive method for early detection of subclinical respiratory disease and of the results of treatment in horses.

Epithelial expression of mRNA and protein for IL-6, IL-10 and TNF-alpha in endobronchial biopsies in horses with recurrent airway obstruction

Background

The aim of this study was to evaluate the contribution of bronchial epithelium to airway inflammation, with focus on mRNA and protein expression of cytokines of innate immunity IL-6, IL-10 and TNF-α, in horses with Recurrent Airway Obstruction (RAO) during exacerbation and in remission.

Results

Despite marked clinical and physiologic alterations between exacerbation and after remission in the RAO horses no differences were detected in either cytokine mRNA or protein levels. Moreover, the expression of investigated cytokines in RAO horses on pasture did not differ from controls.

In comparing real-time PCR analysis to results of immunohistochemistry only IL-10 mRNA and protein levels in RAO horses on pasture were significantly correlated (r_s = 0.893, p = 0.007). Curiously, in controls examined on pasture the TNF-α protein level was positively correlated to IL-10 mRNA expression (r_s = 0.967, p = 0.007) and negatively correlated to IL-6 mRNA expression (r_s = -0.971, p = 0.001).

Conclusion

Given the complementary relationship of assessing cytokines directly by immunohistochemistry, or indirectly by PCR to mRNA, the lack of significant changes in either mRNA or protein levels of IL-6, IL-10 or TNF-α mRNA in RAO horses in exacerbation suggests that these particular cytokines in bronchial tissue may not play a substantive role in the active inflammation of this disease. To support this contention further studies examining time dependency of expression of IL-6, IL-10 or TNF-α are needed, as is expansion of the range of cytokines to include other key regulators of airway inflammation.

Partial divergence of cytokine mRNA expression in bronchial tissues compared to bronchoalveolar lavage cells in horses with recurrent airway obstruction

The aim of this study was to investigate mRNA levels of cytokines in bronchial epithelium in horses with recurrent airway obstruction (RAO) during acute crisis and remission. Additionally, cytokine mRNA levels in endobronchial biopsies and bronchoalveolar lavage (BAL) cells were compared. Seven RAO horses were examined while in respiratory crisis following provocation and again while in remission after 2 months on pasture, during which time six healthy horses on pasture were also examined. Quantitative real-time PCR (RT-PCR) was used to assess mRNA expression for cytokines IL-5, IL-6, IL-8, IL-10, IL-17 and transforming growth factor beta1 (TGF-beta1) in endobronchial biopsies and bronchoalveolar lavage. Expression of IL-8 mRNA was significantly upregulated during crisis in both endobronchial biopsies and BAL cells (p=0.036), while there was a similar trend for upregulation of IL-10 mRNA only in BAL cells that approached significance (p=0.059). Moreover, during crisis the expression of IL-8 mRNA in BAL cells was positively correlated to relative IL-6 mRNA expression (r(s)=0.971, p=0.001) and bronchial epithelial expression of IL-10 and TGF-beta1 mRNA were positively correlated (r(s)=0.943, p=0.005). In comparing the relationship of mRNA expression in BAL to biopsy in individual RAO horses, there was a positive correlation with IL-6 to IL-8 mRNA expression in BAL during respiratory crisis (r(s)=0.971, p=0.001) that also correlated positively with IL-8 expression in biopsies on pasture (r(s)=0.986, p<0.0001 for both). Regarding RAO horses at pasture versus controls neither the cytokine mRNA levels in endobronchial biopsy nor in BAL cells differed significantly. These results further support previous findings that IL-8 mRNA in both BAL cells and bronchial epithelium is upregulated in RAO horses during crisis. However, apart from IL-8, it appears that expression of other cytokines, including IL-5, IL-6, IL-10, IL-17 and TGF-beta1 in bronchial epithelium does not necessarily mirror cytokine expression in BAL cells in individual horses with RAO. Accordingly, examination of markers of inflammation in endobronchial tissue provides complementary but not necessarily identical information to that obtained in BAL cells. Given the potential for repeated sampling over time bronchial biopsy can serve as an invaluable additional tool for investigation of time-dependent changes in inflammatory process in this animal model of asthma.

Change in blood antioxidant status of horses moved from a stable following diagnosis of equine motor neuron disease

The antioxidant status of 10 horses living in stable 1 where 2 cases of equine motor neuron disease had previously been diagnosed was assessed before and 9 weeks after moving to another stable. Duration of residence in stable 1, subsequent moving, or both, significantly affected several parameters of the antioxidant status.

Effects of exercise and oral antioxidant supplementation enriched in (n−3) fatty acids on blood oxidant markers and erythrocyte membrane fluidity in horses

The aim of this study was to investigate in a placebo-controlled field study the effect of a (n-3)-vitamin supplementation on erythrocyte membrane fluidity (EMF), oxidant/antioxidant markers and plasmatic omega3/omega6 fatty acid ratio (FAR) in 12 eventing horses. Venous blood was sampled at rest before (PRE) and after (POST) a three week treatment period with either the supplement (group S, n=6) or a placebo (group P, n=6) as well as after 15min (POST E15') and 24h (POST E24h) after a standardised exercise test. The following markers were analysed: EMF, plasma antioxidant capacity of water and lipid soluble components, ascorbic acid, uric acid (UA), glutathione (reduced: GSH, oxidised: GSSG), vitamin E (Vit E), beta-carotene, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity, selenium, copper (Cu), zinc (Zn), oxidised proteins (Protox), lipid peroxides (Pool) and FAR. EMF did not differ between group S and P after treatment, but GPx remained unchanged in group S whereas it decreased in group P and plasma Cu/Zn ratio remained unchanged whereas it increased in group P. FAR were significantly increased in group S. Exercise induced a significant decrease of EMF (POST vs. E24h) in both groups, but which was significantly lower at E15' in group S than in group P. Exercise induced a significant increase of UA and ACW (POST vs. E15') and Protox (POST vs. E24h) in both groups. An exercise-related decrease in GSH and Pool (POST vs. E15') was found in group P, whereas Vit E and FAR (POST vs. E24h) significantly decreased in both groups. The study showed that exercise induced a decrease in EMF in horses associated with changes of blood oxidative balance. The (omega-3)-vitamin supplementation tested improved the oxidative balance poorly but delayed the exercise-induced decrease of EMF and increased the FAR.

Relevance of using a human microarray to study gene expression in heaves-affected horses

Environmental causes of heaves are well described, but the molecular mechanisms of the disease remain unclear. Previous studies have highlighted the implications of variations in gene expression, most using reverse transcription polymerase chain reaction (RT-PCR). This well-known technique limits the number of genes that can be studied in a single assay. Microarray appears to be a valuable tool to by-pass this limitation, but so far there has been no equine-specific microarray available on the market. The present study was performed to determine whether a human microarray could be used to study gene expression in nucleated cells originating from peripheral blood and bronchoalveolar lavage fluid (BALF) in heaves-affected horses. With a four-fold cut-off, a total of 46 candidates were identified with differentially regulated genes between heaves-affected horses and controls. A real-time quantitative RT-PCR (RT-QPCR) conducted on a selection of genes, determined on the basis of previous publications, was used to validate the microarray results. The microarray failed to detect the presence of interleukin (IL)-1beta and IL-8 mRNA in the nucleated cells from BALF otherwise confirmed by real-time RT-QPCR. Although some candidate genes have been identified using this method, a complete expression profile of genes related to heaves could not be obtained with the use of the human microarray.

Plasma concentrations of myeloperoxidase in endurance and 3-day event horses after a competition

REASON FOR PERFORMING STUDY

In man, exercise of any type has been shown to induce neutrophil degranulation and respiratory burst activity, as well as an increase in plasma myeloperoxidase (MPO), a specific enzyme of neutrophil azurophilic granules with a strong oxidative activity. Until now, it is not known whether this is the same in horses.

OBJECTIVES

To study whether degranulation of blood neutrophils may be induced by exercise by measuring the total concentration of MPO and assess the possible influence of type of competition on this exercise-induced adjustment.

METHODS

Blood was sampled before, and 30 min after, the course, in 9 ponies performing the Phase D of a national 3-day event championship (CIC*), and in 7 endurance horses participating at the European endurance championship 2005. White blood cells and granulocytes, total plasma proteins, creatine phosphokinase (CK), and total MPO contents were determined from blood samples. In addition, blood was taken from all ponies and 4 of the endurance horses 5 min after completion of the course to give some idea of the intensity of exercise.

RESULTS

The mean blood lactate was 15.8 +/- 5.8 mmol/l after the CIC* and 2.7 +/- 0.2 mmol/l after the 160 km course. Performing both competitions induced a significant increase in CK and MPO. After the endurance course, the number of granulocytes significantly increased. Whilst there was no significant correlation between the measurements in CIC* ponies, MPO was significantly correlated with granulocyte count (r2 = 0.776) and CK (r2 = 0.586) in endurance horses.

CONCLUSIONS

Intense exercise induces an activation of blood granulocytes, with degranulation of neutrophils and release of MPO. The plasmatic MPO concentration after endurance was higher than the values reported in some inflammatory pathological conditions.

POTENTIAL RELEVANCE

This phenomenon may partly contribute to the occurrence of an exercise-induced oxidative stress and to the alteration of muscular membrane permeability. Further studies should be conducted to assess the possible relationship between MPO concentration and markers of oxidative stress in performance horses.

Assessment of the oxidant–antioxidant blood balance in a field exercise test in Standardbredand eventing horses

The aim of this study was to determine which oxidant–antioxidant blood markers are of interest for a field exercise test (ET) performed on a racetrack. Healthy Standardbred horses (S:n= 12) and healthy eventing horses (E:n=12) were investigated. Exercise was monitored by measuring velocity (V), heart rate (HR), and plasma lactate (LA). Whilst maximal LA did not differ (11.8±0.88 mmol l−1), maximalV(S: 12.3±0.17 m s−1versusE: 11.1±0.24 m s−1,P<0.05) and final HR (S: 222±1versusE: 203±8 beats min−1,P<0.05) were significantly different between groups. Venous blood was collected at rest (R) prior to ET and the following oxidant–antioxidant markers were determined: uric acid (UA), ascorbic acid (AA), α-tocopherol (Vit E), vitamin A (Vit A), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione (reduced: GSH and oxidized: GSSG), glutathione redox ratio (GRR), copper (Cu), zinc (Zn) and selenium (Se), oxidized proteins (Protox), lipid peroxides (Pool), antioxidant capacity of water-soluble components (ACW) and antioxidant capacity of lipid-soluble components (ACL). The following markers were further determined 15 min (E15) after the ET: UA, ACW, AA, GSH, Protox, Pool, ACL. Standardbreds had significantly higher concentrations of ACW, GSH, ACL and Protox, whilst Se, Zn and SOD were significantly lower than in eventing horses. Exercise induced a significant increase in ACW and UA. GSH decreased in eventing horses and Pool significantly decreased in both horse groups. This study describes a field ET of high intensity for Standardbred and eventing horses, which could be performed by all animals tested. By sampling blood at rest and at E15, changes of the hydrophilic antioxidant defence were partially assessed, whereas no interpretable changes of the lipophilic antioxidants and of oxidation markers (Protox, Pool) could be detected.

Myeloperoxidase concentration in bronchoalveolar lavage fluid from healthy horses and those with recurrent airway obstruction

The aim of this work was to measure the myeloperoxidase (MPO) concentration in bronchoalveolar lavage (BAL) fluid collected from horses with recurrent airway obstruction (RAO), both in crisis and in remission, as well as from healthy horses. Seven horses with RAO were exposed to moldy hay until the maximum change in pleural pressure was greater than 1.5 kPa. At that point, BAL was performed, and the total cell counts and percentages in the fluid were immediately determined. To measure the MPO concentration in BAL-fluid supernatant, we used a specific enzyme-linked immunosorbent assay with polyclonal antibodies against equine MPO. The tests were repeated on the horses with RAO after they had spent 2 mo on pasture. Six healthy horses serving as controls underwent the same tests. The absolute and relative neutrophil counts and the MPO concentration in the BAL fluid were significantly greater in the horses with an RAO crisis than in the control horses. After 2 mo on pasture, the horses that had been in RAO crisis were clinically normal, and their neutrophil counts and MPO levels in BAL fluid had significantly decreased; during remission their neutrophil counts were not significantly different from those in the healthy horses, but their MPO concentration remained significantly higher. This study showed that determining the MPO concentration in a horse's BAL fluid is technically possible and that during remission from RAO the concentration remains higher than normal. Thus, MPO may be a marker of neutrophil presence and activation in the lower airways.

DNA binding activity of transcription factors in bronchial cells of horses with recurrent airway obstruction

Horses with recurrent airway obstruction (RAO) present many similarities with human asthmatics including airway inflammation, hyperresponsiveness, reversible obstruction, and increased NF-kappaB expression. Studies in experimental asthma models have shown that transcriptions factors such as activator protein-1 (AP-1), GATA-3, cyclic AMP response element binding protein (CREB) and CAAT/enhancer binding protein (C/EBP) may also play an important role in airway inflammation. The purpose of this study was to measure DNA binding activity of these transcription factors in the airways of horses with RAO and to compare it to pulmonary function and bronchoalveolar lavage fluid (BALF) cytology. Seven horses with RAO and six control animals were studied during a moldy hay challenge and after 2 months at pasture. Pulmonary function, BALF cytology and transcription factors' activities in bronchial brushings were measured during hay and pasture exposures. During moldy hay challenge, RAO-affected horses developed severe airway obstruction and inflammation and a significantly higher airway AP-1 binding activity than in controls. After 2 months on pasture, pulmonary function and airway AP-1 binding activity were not different between RAO and control horses. The DNA binding activity of CREB in airways of RAO-affected horses increased significantly after 2 months at pasture and became higher than in controls. A significant positive correlation was detected between AP-1 binding activity and indicators of airway obstruction and inflammation. Airway GATA-3, CEBP and CREB binding activities were negatively correlated with indices of airway obstruction. However, contrarily to CREB binding activity, GATA-3 and CEBP binding activities were not different between RAO and control horses and were unaffected by changes in environment. These data support the view that AP-1 and CREB play a role in modulating airway inflammation in horses with RAO.

Effect of beclomethasone dipropionate and dexamethasone isonicotinate on lung function, bronchoalveolar lavage fluid cytology, and transcription factor expression in airways of horses with recurrent airway obstruction

Glucocorticoid (GC) therapy is recognized to be effective for the treatment of recurrent airway obstruction (RAO) in horses. Anti-inflammatory properties of GC are thought to be mediated by suppression of inflammatory gene expression via inhibition of transcription factors such as nuclear factor-kappaB (NF-kappaB) and activator protein-1 (AP-1). The purpose of this study was to evaluate the effect of low-dose inhaled beclomethasone dipropionate and injectable dexamethasone 21-isonicotinate on clinical signs, pulmonary function, airway cytology, and activity of NF-kappaB and AP-1 in bronchial cells of RAO-affected horses. Seven horses with RAO were exposed to moldy hay until they developed airway obstruction on 3 separate occasions. In a crossover design, they were then treated with a placebo (injection on day 1), inhaled beclomethasone (500 microg q12h for 10 days), or dexamethasone (0.06 mg/kg, IM on day 1) and monitored for 10 days. Pulmonary function, bronchoalveolar lavage fluid cytology, and NF-kappaB and AP-1 activity in bronchial brushing cells were measured before (day 1) and after treatment (day 10). Treatment with beclomethasone resulted in significantly improved pulmonary function of RAO-affected horses compared with placebo and dexamethasone treatments. However, none of the treatments had an effect on bronchoalveolar lavage fluid cytology or NF-kappaB and AP-1 activity. These findings reveal that, in a model of severe RAO, the benefits of low-dose inhaled beclomethasone on pulmonary function are not accompanied by a decrease in airway inflammatory cells or a suppression of transcription factors NF-kappaB and AP-1 DNA-binding activity.

Effect of oral antioxidant supplementation on blood antioxidant status in trained thoroughbred horses

The oxidant/antioxidant equilibrium of trained thoroughbred horses (n = 40) was assessed on three occasions during a period of three months under field conditions by blood antioxidant markers analysis, i.e. plasma ascorbic acid (AA), plasma antioxidant capacity of water-soluble components (ACW), whole blood (GSH) and oxidised (GSSG) glutathione, plasma alpha-tocopherol and beta-carotene, plasma antioxidant capacity of lipid-soluble components (ACL), red blood cell superoxide dismutase (SOD) and glutathione-peroxidase activity (GPx) and plasma trace-elements, i.e. selenium (Se), copper (Cu), zinc (Zn). A control group of ten horses receiving a placebo and an antioxidant group of 30 horses orally supplemented with an antioxidant mixture were randomly formed. An antioxidant imbalance was observed after three months in the control group, reflected by a significant decrease in GSH, SOD, GPx, Se (P < 0.05) and a significant increase in GSSG (P < 0.05). The antioxidant supplement prevented GPx and Se decrease and significantly increased ACW, alpha-tocopherol, beta-carotene and ACL (P < 0.05). Significant sex- or age-related differences were found for AA, ACW, alpha-tocopherol, SOD, GPx and Se, and there were significant correlations between ACW-AA, ACL-alpha-tocopherol, GPx-Se, CPK-Se, CPK-alpha-tocopherol and CPK-Cu. This field study has shown that trained thoroughbred horses undergo significant changes of several blood antioxidant markers and that oral antioxidant supplementation might partially counterbalance these changes by improving the hydrophilic, lipophilic and enzymatic antioxidant blood capacity.

Influence of breathing pattern and lung inflation on impulse oscillometry measurements in horses

The objective of this paper was to determine if changes in ventilation patterns could influence the outcome of respiratory function measurements performed with our impulse oscillometry system (IOS) in horses. In a first study, IOS tests were performed in vitro on six isolated equine lungs. Lung inflation levels were controlled by modifying depressurisation inside an artificial thorax and different ventilation patterns were imposed. In a second in vivo study, transient variations in breathing pattern were evaluated both with the IOS and a current reference technique (CRT) in five healthy mature horses after an intravenous (i.v.) injection of lobeline hydrochloride. In both studies, respiratory rate (RR, range: 7-42 breaths/min.) and tidal volume (V(T), range: 0.4-25 L) had minor or no influence on IOS parameters. The influence of lung inflation, most marked for resistance at 5 Hz (R(5 Hz)), was limited for the considered physiological range. In vivo, statistical models indicated that maximal changes in pleural pressure (Max Delta Ppl) and peak flows were the main determinants of the variability of the resistance (R(rs)) and the reactance (X(rs)) of the respiratory system. The fourfold increase in baseline Max Delta Ppl and peak flows obtained during hyperpnoea caused a significant increase in R(rs) at 5 and 10 Hz and a decrease in X(rs) at all frequencies. We conclude that IOS parameters are not influenced by tachypnoea, but will reflect alterations in respiratory mechanics caused by hyperpnoeic breathing.

Use of the impulse oscillometry system for testing pulmonary function during methacholine bronchoprovocation in horses

OBJECTIVE

To compare sensitivity of the impulse oscillometry system (IOS) with that of the conventional reference technique (CRT; ie, esophageal balloon method) for pulmonary function testing in horses.

ANIMALS

10 horses (4 healthy; 6 with recurrent airway obstruction [heaves] in remission).

PROCEDURE

Healthy horses (group-A horses) and heaves-affected horses (group-B horses) were housed in a controlled environment. At each step of a methacholine bronchoprovocation test, threshold concentration (TC(2SD); results in a 2-fold increase in SD of a value) and sensitivity index (SI) were determined for respiratory tract system resistance (R(rs)) and respiratory tract system reactance (X(rs)) at 5 to 20 Hz by use of IOS and for total pulmonary resistance (RL) and dynamic lung compliance (C(dyn)), by use of CRT.

RESULTS

Bronchoconstriction resulted in an increase in R(rs) at 5 Hz (R(5Hz)) and a decrease in X(rs) at all frequencies. Most sensitive parameters were X(rs) at 5 Hz (X(5Hz)), R(5Hz), and R(5Hz):R(10Hz) ratio; RL and the provocation concentration of methacholine resulting in a 35% decrease in dynamic compliance (PC(35)C(dyn)) were significantly less sensitive than these IOS parameters. The TC(2SD) for X(rs) at 5 and 10 Hz was significantly lower in group-B horses, compared with group-A horses. The lowest TC(2SD) was obtained for X(5Hz) in group-B horses and R(5Hz) in group-A horses.

CONCLUSIONS AND CLINICAL RELEVANCE

In contrast to CRT parameters, IOS parameters were significantly more sensitive for testing pulmonary function. The IOS provides a practical and noninvasive pulmonary function test that may be useful in assessing subclinical changes in horses.

Sternal recumbency or suspension by the hind legs immediately after delivery improves respiratory and metabolic adaptation to extra uterine life in newborn calves delivered by caesarean section

The aim of this study was to evaluate the effect of body positioning immediately after delivery on respiratory and metabolic adaptation to extra-uterine life in newborn calves. One hundred and one Belgian White and Blue calves were delivered at term by an elective caesarean section and were assigned into three categories according to the body position imposed immediately after umbilical cord rupture: 71 calves were placed in lateral recumbency; 16 calves were placed in sternal recumbency and 14 calves were suspended by the hind legs for less than 90 seconds (75 +/- 5 s). Following this initial body position, the calves were allowed to move without restraint. They were examined at birth, 5, 15, 30, 45 and 60 minutes, and 2, 3, 6, 12 and 24 hours after birth by the following measurements: physical examination, heart rate, arterial blood gas analysis, pulmonary function tests using the esophageal balloon catheter technique, arterial and venous blood acid-base balance analysis, rectal temperature, jugular venous blood sampling for the determination of blood glucose, plasma lactate and serum cortisol concentrations, haematologic variables and passive immune transfer variables. Body positioning immediately after delivery clearly influenced respiratory and metabolic adaptation to extra-uterine life in term calves delivered by an elective caesarean section. Systematic sternal recumbency and suspension by the hind legs for less than 90 seconds immediately after umbilical cord rupture had a positive functional impact on postnatal pulmonary mechanics and gas exchange and on postnatal correction of mixed acidosis present at birth, contributing in turn to an enhanced passive immune transfer. These two body positions should be encouraged to improve adaptation at birth in healthy term calves delivered by an elective caesarean section. Evaluation of possible side-effects is required before application in severely asphyxiated calves.

Effect of nutritional antioxidant supplementation on systemic and pulmonary antioxidant status, airway inflammation and lung function in heaves-affected horses

An oxidant/antioxidant imbalance in favour of oxidants has been identified as playing a decisive role in the pathogenesis of chronic inflammatory airway diseases. Nutritional antioxidant supplementation might reduce oxidative damage by enhancement of the antioxidant defence, thereby modulating inflammatory processes. In a placebo-controlled, blind study, it was tested whether a dietary antioxidant supplement administered for 4 weeks would improve lung function and reduce airway inflammation in heaves-affected horses. Eight horses in clinical remission of heaves were investigated at rest and after a standardised exercise test before and after treatment with an antioxidant supplement (consisting of a mixture of natural antioxidants including vitamins E and C and selenium from a variety of sources) or placebo (oatfeed pellets without additive). Pulmonary function and exercise tolerance were monitored; systemic and pulmonary lining fluid uric acid, glutathione and 8-epi-PGF(2alpha) were analysed, and bronchoalveolar lavage (BAL) cytology and inflammatory scoring of the airways were performed. The antioxidant treatment significantly improved exercise tolerance and significantly reduced endoscopic inflammatory score. Plasma uric acid concentrations were significantly reduced, suggesting downregulation of the xanthine-dehydrogenase and xanthine-oxydase pathway. Haemolysate glutathione showed a nonsignificant trend to increase, while plasma 8-epi-PGF(2alpha) remained unchanged. Pulmonary markers and BAL cytology were not significantly affected by antioxidant supplementation. The present study suggests that the antioxidant supplement tested modulated oxidant/antioxidant balance and airway inflammation of heaves-affected horses.