Gene-expression profiling of endomyocardial biopsies from dogs with dilated cardiomyopathy phenotype

INTRODUCTION

The employment of advanced molecular biology technologies has expanded the diagnostic investigation of cardiomyopathies in dogs; these technologies have predominantly been performed on postmortem samples, although the recent use of endomyocardial biopsy in living dogs has enabled a better premortem diagnostic approach to study the myocardial injury.

ANIMALS, MATERIALS, AND METHODS

Endomyocardial biopsies were collected in nine dogs with a dilated cardiomyopathy phenotype (DCM-p) and congestive heart failure and submitted to histologic examination, next-generation sequencing (NGS), and polymerase chain reaction analysis. Data from three healthy dogs (Fastq files) were retrieved from a previously approved study and used as a control group for ribonucleic acid sequencing.

RESULTS

Histologic examination revealed endocardial fibrosis in 6 of 9 dogs, whereas lymphocytic interstitial infiltrates were detected in 2 of 9 dogs, and lymphoplasmacytic and macrophage infiltrates were detected in 1 of 9 dogs. On polymerase chain reaction analysis, two dogs tested positive for canine parvovirus 2 and one dog for canine distemper virus. Gene-expression pathways involved in cellular energy metabolism (especially carbohydrates-insulin) and cardiac structural proteins were different in all DCM-p dogs compared to those in the control group. When dogs with lymphocytic interstitial infiltrates were compared to those in the control group, NGS analysis revealed the predominant role of genes related to inflammation and pathogen infection.

CONCLUSIONS

NGS technology performed on in vivo endomyocardial biopsies has identified different molecular and genetic factors that could play a role in the development and/or progression of DCM-p in dogs.

Tricuspid atresia with atrial and ventricular septal defects in a kitten

A 45-days-old mixed-breed female cat was referred to a veterinary specialty hospital for evaluation due to poor general condition, dyspnea of possible cardiac origin, and a heart murmur. The results of the physical examination, thoracic radiography, and echocardiography led to a diagnosis of hypotrophy of the right ventricle, tricuspid atresia, and atrial septal defect. Cardiovascular pathological findings confirmed the clinical diagnosis in addition to the observation of a ventricular septal defect. To the authors' knowledge, this is the first report of tricuspid atresia with atrial septal defect and ventricular septal defect in a cat.

Fatal acute lung injury after balloon valvuloplasty in a dog with pulmonary stenosis

A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure. Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1.36. Echocardiography immediately after PBV showed a significant reduction in right atrial and ventricular size, improved opening and mobility of the pulmonary valve leaflets, and a 75% reduction in the pulmonary pressure gradient from 158 mmHg pre-operative to 40 mmHg post-operative. The dog recovered well from anesthesia, but 2 h later, it suddenly showed severe respiratory distress. Focus cardiac ultrasound showed increased left cardiac size with echocardiographic signs of high left ventricular filling pressure. Bedside lung ultrasound showed diffuse numerous-to-confluent B lines, compatible with a severe alveolar-interstitial syndrome. The dog was treated with furosemide, helmet continuous positive airway pressure, and then mechanical ventilation but without success. At post-mortem evaluation, histological examination of the lung showed diffuse, severe broncho-alveolar edema with mixed leukocyte, fibrin, and red blood cell infiltrate. Moreover, severe congestion and multifocal alveolar hemorrhages were evident. All findings were compatible with fatal acute lung injury after PBV secondary to pulmonary reperfusion-ischemia injury and increased pulmonary capillary hydrostatic pressure. Based on the present case, acute lung injury should be considered as a rare but serious complication of PBV.

Viral load, tissue distribution and histopathological lesions in goats naturally and experimentally infected with the Small Ruminant Lentivirus Genotype E (subtype E1 Roccaverano strain)

Small Ruminant Lentivirus (SRLV) subtype E1, also known as Roccaverano strain, is considered a low pathogenic virus on the basis of natural genetic deletions, in vitro properties and on-farm observations. In order to gain more knowledge on this atypical lentivirus we investigated the in vivo tropism of Roccaverano strain in both, experimentally and naturally infected goats. Antibody responses were monitored as well as tissue distribution and viral load, evaluated by real time PCR on single spliced (gag/env) and multiple spliced (rev) RNA targets respectively, that were compared to histopathological lesions. Lymph nodes, spleen, alveolar macrophages and mammary gland turned out to be the main tissue reservoirs of genotype E1-provirus. Moreover, mammary gland and/or mammary lymph nodes acted as active replication sites in dairy goats, supporting the lactogenic transmission of this virus. Notably, a direct association between viral load and concomitant infection or inflammatory processes was evident within organs such as spleen, lung and testis. Our results validate the low pathogenicity designation of SRLV genotype E1 in vivo, and confirm the monocyte-macrophage cell lineage as the main virus reservoir of this genotype. Accordingly, SRLV genotype E displays a tropism towards all tissues characterized by an abundant presence of these cells, either for their own anatomical structure or for an occasional infectious/inflammatory status.

Swallowing Disturbances and Psychiatric Profile in Older Adults: The GreatAGE Study

Introduction

Several studies have reported controversial links between swallowing disturbances (SD) and psychiatric disorders in older age. The available data on the epidemiology of SD in the general population are scarce and often conflicting, because of numerous methodological factors source of possible counfounders.

Objectives

We aimed to screen the presence of psychiatric and cognitive disorders associated with SD in a random sampling of the general population ≥ 65.

Methods

A sample of 1127 elderly individuals collected in a population-based study (GreatAGE) in Castellana Grotte (53,50% males, mean age 74.1 ± 6.3 years), South-East Italy, were mailed a validated self-report questionnaire to assess SD (Eating Assessment Tool-EAT10). Psychiatric disorders and symptoms [assessed with Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, Geriatric Depression Scale-30 (GDS-30) and Symptom Checklist Revised-90 (SCL-90R)], cognitive functions were assessed with a comprehensive neuropsychological battery, neurological exam, and demographics were compared in participants with and without SD using t-tests and Mann–Whitney U-test.

Results

The prevalence rates of SD amounted at 5.97%. Psychiatric diagnosis (24.22% of the sample) was statistically significant associated with SD (EAT ≥ 3, P = 0.038), and a trend was found for major depressive disorder and generalized anxiety disorder. Among SCL-90R domains, only anxiety showed a significant association with EAT ≥ 3 (P = 0.006). GDS-30 score was found to be higher in subjects with SD (P = 0.008). Cognitive functions did not differ between the two groups except for an increasing trend for Clinical Dementia Rating Scale in EAT ≥ 3 (P = 0.058).

Conclusions

These preliminary results showed an association between SD in older age and late-life major depression and anxiety disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Educational level influenced the gold standard diagnosis of late-life depression in the GreatAGE study

Introduction

The validity of the 30-item Geriatric Depression Scale (GDS-30) in detecting late-life depression (LLD) requires a certain level of cognitive functioning. Further research is needed in population-based setting on other socio-demographic and cognitive variables that could potentially influence the accuracy of clinician rated depression.

Objective

To compare the diagnostic accuracy of two instruments used to assess depressive disorders [(GDS-30) and the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID)] among three groups with different levels of cognitive functioning (normal, Mild Cognitive Impairment – MCI, Subjective Memory Complain – SMC) in a random sampling of the general population 65+ years.

Methods

The sample, collected in a population-based study (GreatAGE Study) among the older residents of Castellana Grotte, South-East Italy, included 844 subjects (54.50% males). A standardized neuropsychological battery was used to assess MCI, SMC and depressive symptoms (GDS-30). Depressive syndromes were diagnosed through the SCID IV-TR. Socio-demographic and cognitive variables were taken into account in influencing SCID performance.

Results

According to the SCID, the rate of depressive disorders was 12.56%. At the optimal cut-off score (≥ 4), GDS-30 had 65.1% sensitivity and 68.4% specificity in diagnosing depressive symptoms. Using a more conservative cut-off (≥ 10), the GDS-30 specificity reached 91.1% while sensitivity dropped to 37,7%. The three cognitive subgroups did not differ in the rate of depression diagnosis. Educational level is the only variable associated to the SCID diagnostic performance (P = 0.015).

Conclusions

At the optimal cut-off, GDS-30 identified lower levels of screening accuracy for subjects with normal cognition rather than for SMC (AUC 0.792 vs. 0.692); educational attainment possibly may modulate diagnostic clinician performance.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Bartonella-associated inflammatory cardiomyopathy in a dog

A 6-year-old, male, mongrel dog was presented for acute onset of dyspnea and cough. At admission, the dog was cachectic and severely depressed. The electrocardiogram showed a sinus rhythm conducted with left bundle truncular branch block and interrupted by frequent multiform ventricular ectopic beats organized in allorhythmias. Thoracic radiographs revealed a marked cardiomegaly with perihilar edema, whereas transthoracic echocardiography revealed a dilated cardiomyopathy with segmental dyskinesis. Furosemide, enalapril, pimobendan, and mexiletine were prescribed, and a Holter was scheduled after resolution of congestive heart failure. Three days later, the dog died suddenly during sleep. Histopathology revealed diffuse myocyte hypertrophy with multifocal hemorrhages, alternating to areas of severe replacement fibrosis and lymphoplasmocytic infiltrates. Immunohystochemistry stains were strongly positive for T-lymphocyte infiltration (CD3) and weakly positive for B-lymphocytes (CD79). Polymerase chain reaction was positive for Bartonella spp. Based on these results, a post-mortem diagnosis of bacterial inflammatory cardiomyopathy was made.

Adrenal Myelolipoma in a Dog

Abdominal ultrasound examination in an 11-year-old, intact, female Labrador dog with hepatic disease revealed a nodular swelling of the left adrenal gland. Hyperadrenocorticism was suspected, but endocrine tests were negative. At the owner's request, an adrenalectomy was performed. Grossly, a nodular mass protruded from the external surface of the left adrenal gland and in cut section was hemorrhagic and effaced the cortical and medullary regions. Histologic examination revealed a cortical neoplasm with medullary involvement. The mass was composed of well-differentiated adipose cells, megakaryocytes, hematopoietic cells, and macrophages containing hemosiderin deposits. A diagnosis of cortical adrenal myelolipoma was made.

Anatomopathological staging of feline hypertrophic cardiomyopathy through quantitative evaluation based on morphometric and histopathological data

Diagnosis of feline hypertrophic cardiomyopathy (HCM) is both clinical and anatomopathological. Since standardized echocardiographic parameters have previously been established for its diagnosis and classification, the aim of the present study is to provide an original, complete and repeatable quantitative anatomopathological evaluation of this myocardial disease. Since ES-HCM is a clearly defined clinicopathological entity of feline HCM, the present study also aims to investigate its temporal evolution. The hearts of 21 cats with previous diagnosis or suspicion of HCM and 6 control animals were submitted for morphometric and histopathological investigations. The proposed quantitative assessment of gross and histopathological features of HCM appears to be original and repeatable. Correlations between morphometric data allow to establish that the progression to the end-stage phenotypes, primarily characterized by increase in left ventricular fibrous tissue deposition, is accompanied by dilation of left ventricular lumen (P=0.0004) and left atrium (P=0.0017) and increase in intramural coronary arteriosclerosis (P=0.0293).

Urinary tract infections in sows in Italy: accuracy of urinalysis and urine culture against histological findings

In order to investigate the prevalence of urinary tract infections (UTI) in sow, lower urinary tract (LUT), kidney and urine samples were collected at slaughterhouse from 65 multiparous culled sows. Histopathology was performed on urethra, urinary bladder and -kidney sections. Urine collected by cystocentesis was analysed for physical and biochemical parameters, in addition to microscopic examination of the sediment and quantitative culture ( > 10(5) CFU/ml urine). The diagnostic accuracy of urinalysis and urine culture was calculated for the parameters that correlated with histological diagnosis: bilateral chronic lesions were found in 54 per cent of kidney samples and diffuse/multifocal lymphoplasmacytic infiltration of the submucosa in 53 per cent of the bladder and 68 per cent of the urethra samples. In 49 per cent of cases, the co-occurrence of bladder and urethra lesions was statistically significant (P < 0.009). Turbid urine (80 per cent sensitivity, 50 per cent specificity), > 5 white blood cells per high-power field (34 per cent sensitivity, 90 per cent specificity), intracellular or free bacteria (43 per cent sensitivity, 90 per cent specificity), and urine culture (49 per cent sensitivity, 97 per cent specificity) correlated with a finding of histopathological changes in the bladder. UTI appears to be common in culled sows in northern Italy. Compared with histopathology, urinalysis and urine culture showed low sensitivity but high specificity in detecting UTI.

Malignant pleural mesothelioma in a female lion (Panthera leo)

An 18-year-old female lion (Panthera leo) was referred to the Department of Animal Pathology of the University of Turin (Italy). At necropsy, multiple nodular, 4-20-mm, confluent white firm nodules were scattered throughout the pleural surfaces of the thoracic wall and of the lungs. Histological lesions were represented by proliferations of papillary structures lined by cuboidal basophilic mesothelial cells with large, oval nuclei and abundant granular eosinophilic cytoplasm. Immunohistochemistry revealed immunoreactivity for pancytokeratin and vimentin. None of the cells expressed calretinin antigen. Asbestos fibers and asbestos bodies were not detected respectively by light microscopy and by Scanning Electron Microscope-Energy Dispersive Spectrometer investigations. On the contrary, chrysotile asbestos were identified in samples from shelter material. Histological and immunohistochemical findings were consistent with the diagnosis of an epithelial malignant mesothelioma. To our best knowledge, this is the first report of a pleural mesothelioma in a lion.

Myocardial Adenomatoid Tumor in Eight Cattle: Evidence for Mesothelial Origin of Bovine Myocardial Epithelial Inclusions

The adenomatoid tumor is an uncommon benign lesion, thus far described only in humans. Adenomatoid tumors typically arise in the genital tract, exceptionally in the heart, and usually represent an incidental finding. Microscopically, they are constituted by epithelioid cells that form tubular structures and anastomosing channels within a fibrous stroma. Mesothelial origin of these lesions is suggested by their immunohistochemical characteristics. In cattle, previously reported myocardial epithelial inclusions are morphologically similar in that the cells are immunoreactive for both cytokeratins and vimentin, and bear surface microvilli. Myocardial lesions found incidentally at slaughter in 8 cattle histologically resembled the so-called bovine myocardial epithelial inclusions and had morphologic and immunohistochemical features consistent with human adenomatoid tumor. All lesions were in the left ventricular myocardium, adjacent to the epicardium, and composed of epithelioid cells that formed cords and tubules, and were immunoreactive for pan-cytokeratins, cytokeratin 5/6, vimentin, calretinin, Wilms' tumor 1 suppressor gene, and CD30 antigen. By electron microscopy, numerous long slender microvilli were associated with desmosomes and tonofibrils. The immunohistochemical and ultrastructural features were considered consistent with mesothelial origin. These lesions, corresponding to the previously described myocardial epithelial inclusions in cattle, might be considered embryologic rests and could represent the bovine counterpart of the human adenomatoid tumor.