RESUMEN
Our understanding of the use of acid-suppressant drugs (ASDs) in companion animals is largely centered around the treatment of acid-related disorders including gastroesophageal reflux and gastrointestinal ulceration. The companion article by Grady et al, JAVMA, October 2024, summarizes our current knowledge of the efficacy of and indications for ASDs for the treatment of acid-related disorders. Far less is understood about both the benefits of and potential for adverse effects of ASDs outside of the parietal cell including those directed toward inflammation and immunomodulation, tumorigenesis, fibrosis, and oxidative stress. In this Currents in One Health article, we summarize the pH-independent properties of ASDs as demonstrated in studies conducted largely in humans and rodents. The objective of this review is to highlight and increase awareness of the pH-independent effects of ASDs to elucidate the need for further veterinary research in this area.
RESUMEN
BACKGROUND: Acid suppressant drugs (ASDs) are commonly used to decrease gastric acid production, but some evidence exists that ASDs exert immunomodulatory effects. Such an effect has not been investigated in dogs for which ASDs are routinely prescribed. HYPOTHESIS: Compared to naïve subjects, dogs treated with ASDs will exhibit differences in leukocyte ratios after treatment. ANIMALS: Fifty-one dogs with mast cell tumors (MCTs). MATERIALS AND METHODS: Dogs with MCT that were either AS naïve or treated with ASDs (i.e., histamine-2-receptor antagonists [H2RA] or proton pump inhibitors [PPI]) were included in this retrospective study. Subjects were categorized into 3 treatment groups (AS naïve, H2RA treated, and PPI treated), and leukocyte ratios (neutrophil:eosinophil, lymphocyte:monocyte, and neutrophil:lymphocyte [NLR]) were calculated before and after treatment. A mixed effects analysis of variance on ranks was used to assess differences in ratios between treatments, between pre- and post-treatment time points, and between pre- and post-time points for each treatment. Concurrent administration of antihistamines, corticosteroids, and chemotherapeutic drugs was assessed as a confounding factor. RESULTS: Famotidine (n = 14/14) and omeprazole (n = 12/12) were the only H2RA and PPI used, respectively. Dogs receiving famotidine had a significant increase in median NLR from pre- to post-treatment (3.429; range, 1.417-15 to 5.631; range, 2.654-92; P < 0.01) compared to PPI treated or AS naïve dogs. No differences existed in chemotherapeutic drug or corticosteroid use between groups. CONCLUSIONS: A significant difference in NLR was identified in famotidine treated dogs compared with omeprazole treated or AS naïve dogs.
Asunto(s)
Enfermedades de los Perros , Famotidina , Antagonistas de los Receptores H2 de la Histamina , Omeprazol , Inhibidores de la Bomba de Protones , Animales , Perros , Enfermedades de los Perros/tratamiento farmacológico , Estudios Retrospectivos , Famotidina/uso terapéutico , Famotidina/farmacología , Antagonistas de los Receptores H2 de la Histamina/farmacología , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Femenino , Masculino , Omeprazol/uso terapéutico , Omeprazol/farmacología , Inhibidores de la Bomba de Protones/uso terapéutico , Inhibidores de la Bomba de Protones/farmacología , Recuento de Leucocitos/veterinaria , Mastocitoma/veterinaria , Mastocitoma/tratamiento farmacológicoRESUMEN
Objectives: (i) To determine the influence of specimen collection protocol (timing and specimen quantity), primary disease process, and pre-existing antimicrobial or immunosuppressive therapy on blood culture (BC) positivity and (ii) To determine agreement between urine culture and BC results. Animals: 701 client-owned dogs. Methods: Multi-institutional retrospective study (2019-2022). Mixed-effect logistic regression was used to determine whether primary disease process, the number of BCs, or the timing of specimen collection was associated with BC positivity. Prediction plots were generated. Associations between urine culture and BC results were performed using logistic regression. Results: Dogs with a positive urine culture were more likely to have a positive BC (OR: 4.36, 95% CI: 2.12-8.97, p = 0.003). Dogs that had three BC specimens had the greatest odds of obtaining a positive BC result (adjusted predictive value: 0.44, 95% CI: 0.21-0.70), although this was not significant. Isolates from 38.5% of dogs with a positive BC had resistance to ≥3 antimicrobial classes. The timing between specimen collection had no significant association with BC positivity. Pre-existing antibiotic or immunosuppressive therapy had no significant association with BC positivity. Clinical relevance: Dogs with a positive urine culture were more likely to have a positive BC result.
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Histamine-2 receptor antagonists such as famotidine and proton pump inhibitors such as esomeprazole are commonly used in canine MCT disease, but direct effects on dog MCs have not been evaluated. Omeprazole is a proton pump inhibitor which has been demonstrated to cause structural and functional changes to in vitro murine mast cells (MCs). It has not yet been determined if esomeprazole, the commercially available and commonly prescribed S-isomer of omeprazole, has similar effects. Our primary study objective was to evaluate and compare the effects of acid suppressants (esomeprazole and famotidine) on MC ultrastructure, viability, and function in vitro using both healthy and neoplastic MCs. Murine bone marrow derived mast cells (BMMC), human LAD2, and canine C2 and BR cells, were used for these studies, representing a single healthy (i.e., BMMCs) MC model and multiple neoplastic MC models (i.e., LAD2, C2, BR), respectively. The rat basophilic leukemic (RBL-2H3) and canine B cell lymphoma 17-71 cell lines served as granulocytic and agranulocytic control lines for experiments, respectively. The treatment effect of acid suppressants on MC ultrastructure was assessed via both light and transmission electron microscopy. Differences in MC viability was assessed between groups via MTS-based, colorimetric assays and flow cytometry. Degranulation was assessed by quantification of ß-hexosaminidase (i.e., LAD2 and RBL-2H3). Esomeprazole-treated MCs of all lines exhibited dramatic time and concentration-dependent alterations in ultrastructure (i.e., increased vacuolization, compromise of cell membrane), increased apoptosis, and altered degranulation responses in comparison to famotidine and vehicle-treated cells. The canine B cell lymphoma cells consistently exhibited either no significant (i.e., cytotoxicity assays) or greatly diminished treatment responses (i.e., apoptosis) compared to MCs. Esomeprazole, but not famotidine, induces significant cytotoxicity, as well as alterations to cell structure and function to multiple lines of in vitro neoplastic MCs. Continued in vitro work investigating the specific mechanisms by which proton pump inhibitors induce these effects, as well as prospective, in vivo work comparing the treatment effects of acid suppressants on canine MCTs, are warranted.
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Esomeprazol , Mastocitos , Ratas , Ratones , Perros , Humanos , Animales , Esomeprazol/farmacología , Esomeprazol/metabolismo , Inhibidores de la Bomba de Protones/farmacología , Inhibidores de la Bomba de Protones/metabolismo , Estudios Prospectivos , Famotidina/metabolismo , Famotidina/farmacología , ApoptosisRESUMEN
OBJECTIVE: To characterize gastrointestinal transit times (GITTs) and pH in dogs, and to compare to data recently described for cats. ANIMALS: 7 healthy, colony-housed Beagles. PROCEDURES: The GITTs and pH were measured using a continuous pH monitoring system. For the first period (prefeeding), food was withheld for 20 hours followed by pH capsule administration. Five hours after capsule administration, dogs were offered 75% of their historical daily caloric intake for 1 hour. For the second period (postfeeding), food was withheld for 24 hours. Dogs were allowed 1 hour to eat, followed by capsule administration. Both periods were repeated 3 times. The GITTs and pH were compared to published feline data. RESULTS: The mean ± SD transit times in dogs for the pre- and postfeeding periods, respectively, were esophageal, 3 ± 5 minutes and 13 ± 37 minutes; gastric, 31 ± 60 minutes and 829 ± 249 minutes; and intestinal, 795 ± 444 minutes and 830 ± 368 minutes. The mean ± SD gastrointestinal pH in dogs for the pre- and postfeeding periods, respectively, were esophageal, 6.6 ± 0.6 and 5.7 ± 1.0; gastric, 3.0 ± 1.4 and 1.8 ± 0.3; intestinal, 7.9 ± 0.3 and 7.7 ± 0.6; first-hour small intestinal, 7.6 ± 0.5 and 7.1 ± 0.4; and last-hour large intestinal, 7.9 ± 0.6 and 7.7 ± 1.0. The first-hour small intestinal pH and total transit times varied between dogs and cats depending on feed period (P = .002 and P = .04, respectively). Post hoc analysis revealed significantly shorter total transit times in dogs prefeeding (P = .005; mean ± SD for cats, 2,441 ± 1,359 minutes; for dogs, 828 ± 439 minutes) and postfeeding (P = .03; mean ± SD for cats, 3,009 ± 1,220 minutes; for dogs, 1,671 ± 513 minutes). Total transit time for dogs was also shorter pre- versus postfeeding (P = .003). CLINICAL RELEVANCE: GITT is faster in Beagles compared to cats, but gastrointestinal pH are similar when fed the same diet.
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Enfermedades de los Gatos , Enfermedades de los Perros , Perros , Gatos , Animales , Tránsito Gastrointestinal , Tracto Gastrointestinal , EstómagoRESUMEN
OBJECTIVES: The aim of this study was to characterize gastrointestinal (GI) transit times and pH in healthy cats. METHODS: GI transit times and pH were measured in six healthy, colony-housed, purpose-bred spayed female cats using a continuous, non-invasive pH monitoring system in a sequential order design. For the first period ('pre-feeding'), food was withheld for 20 h, followed by oral administration of a pH capsule. Five hours post-capsule administration, cats were meal-fed by offering them their daily allowance of food for 1 h. For the second period ('post-feeding'), food was withheld for 24 h and cats were fed for 1 h, after which a pH capsule was orally administered. Studies in both periods were repeated three times. GI transit times and pH were compared between the two periods. RESULTS: The median transit times for the pre- and post-feeding periods, respectively, were: gastric - 94 mins (range 1-4101) and 1068 mins (range 484-5521); intestinal - 1350 mins (range 929-2961) and 1534 mins (range 442-2538); and GI - 1732 mins (range 1105-5451) and 2795 mins (range 926-6563). The median GI pH values for the first and second periods, respectively, were: esophageal - 7.0 (range 3.5-7.8) and 4.5 (range 2.9-6.4); gastric - 2.7 (range 1.7-6.2) and 2.0 (range 1.1-3.3); intestinal - 8.2 (range 7.6-8.7) and 7.8 (range 6.7-8.5); first-hour small intestinal - 8.2 (range 7.4-8.7) and 8.3 (range 7.9-8.6); and last-hour large intestinal - 8.5 (range 7.0-8.9) and 7.8 (range 6.3-8.7). Gastric (P <0.0020) and intestinal pH (P <0.0059) were significantly increased in the pre-feeding period compared with the post-feeding period. CONCLUSIONS AND RELEVANCE: Gastric and intestinal pH differed significantly when the capsule was administered 5 h prior to feeding compared with 1 h after feeding. Transit times for both periods showed high degrees of intra- and inter-individual variability.
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Tránsito Gastrointestinal , Intestino Delgado , Administración Oral , Animales , Gatos , Femenino , Concentración de Iones de Hidrógeno , Factores de TiempoRESUMEN
Tritrichomonas foetus (T. foetus) is a flagellated protozoan parasite that is recognized as a significant cause of diarrhea in domestic cats with a prevalence rate as high as 30%. No drugs have been shown to consistently eliminate T. foetus infection in all cats. Cysteine proteases (CPs) have been identified as mediators of T. foetus-induced adhesion-dependent cytotoxicity to the intestinal epithelium. These CPs represent novel targets for the treatment of feline trichomonosis. However, cats also produce CPs that are part of life-critical systems. Thus, parasitic CPs need to be selectively targeted to reduce the potential for host toxicity. Previous studies have demonstrated the importance of a specific CP, CP30, in mediating bovine and human trichomonad cytopathogenicity. This CP has also recently been identified in feline T. foetus, although the function of this protease in the feline genotype remains unknown. Therefore, the study objectives were to characterize the presence of CP30 in feline T. foetus isolates and to evaluate the effect of targeted inhibition of CP30 on feline T. foetus-induced adhesion dependent cytotoxicity. The presence of CP30 in feline T. foetus isolates was identified by In gel zymography and proteomic analysis, indirect immunofluorescence (IF), and flow cytometry using a rabbit polyclonal antibody that targets bovine T. foetus CP30 (α-CP30). The effect of inhibition of CP30 activity on T. foetus adhesion and cytotoxicity was determined using CFSE-labeled feline T. foetus and crystal violet spectrophotometric assays in a previously validated co-culture model. CP30 expression was confirmed in all feline T. foetus isolates tested by all assays. Targeted inhibition of feline T. foetus CP30 resulted in decreased T. foetus adhesion to and cytotoxicity towards IPEC-J2 monolayers compared to rabbit IgG-treated T. foetus isolates. These studies establish that CP30 is expressed by feline T. foetus isolates and may be an important virulence factor in the cytopathogenicity of feline T. foetus. The results of these studies provide strong evidence-based justification for investigation of CP30 as a novel target for the treatment of feline trichomonosis.
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Enfermedades de los Gatos/parasitología , Proteasas de Cisteína/metabolismo , Diarrea/veterinaria , Infecciones Protozoarias en Animales/parasitología , Tritrichomonas foetus/enzimología , Animales , Gatos , Línea Celular , Técnicas de Cocultivo , Proteasas de Cisteína/genética , Diarrea/parasitología , Genotipo , Mucosa Intestinal/metabolismo , Proteómica , Tritrichomonas foetus/genética , Tritrichomonas foetus/patogenicidadRESUMEN
OBJECTIVE To investigate the effects of specific cysteine protease (CP) inhibitors on cytopathic changes to porcine intestinal epithelial cells induced by Tritrichomonas foetus isolated from naturally infected cats. SAMPLE T foetus isolates from 4 naturally infected cats and nontransformed porcine intestinal epithelial cells. PROCEDURES T foetus isolates were treated with or without 0.1 to 1.0mM of the CP inhibitors antipain, cystatin, leupeptin, and chymostatin and the vinyl sulfone inhibitors WRR-483 and K11777. In-gel gelatin zymography was performed to evaluate the effects of these inhibitors on CP activity of T foetus isolates. Each treated or untreated isolate was also cocultured with monolayers of porcine intestinal epithelial cells for 24 hours, and cytopathic effects of T foetus were evaluated by light microscopy and crystal violet spectrophotometry. RESULTS Results of in-gel gelatin zymography suggested an ability of WRR-483, K11777, and cystatin to target specific zones of CP activity of the T foetus isolates. These inhibitors had no effect on T foetus growth, and the cytopathic changes to the intestinal epithelium induced by all 4 T foetus isolates were significantly inhibited. CONCLUSIONS AND CLINICAL RELEVANCE This study revealed that certain protease inhibitors were capable of inhibiting regions of CP activity (which has been suggested to cause intestinal cell damage in cats) in T foetus organisms and of ameliorating T foetus-induced cytopathic changes to porcine intestinal epithelium in vitro. Although additional research is needed, these inhibitors might be useful in the treatment of cats with trichomonosis.
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Inhibidores de Cisteína Proteinasa/farmacología , Células Epiteliales/efectos de los fármacos , Oligopéptidos/antagonistas & inhibidores , Sulfonas/antagonistas & inhibidores , Tritrichomonas foetus/efectos de los fármacos , Animales , Antipaína/farmacología , Apoptosis/efectos de los fármacos , Gatos , Línea Celular/efectos de los fármacos , Células Epiteliales/parasitología , Oligopéptidos/farmacología , PorcinosRESUMEN
A 3-year-old male castrated domestic shorthair cat was presented with an acute history of lethargy and decreased appetite. Pertinent physical examination abnormalities included palpable irregularity of the right kidney and pain on palpation of the left kidney. Ultrasonographic imaging of the abdomen revealed gas present at the corticomedullary junction of the left kidney, consistent with emphysematous pyelonephritis, as well as emphysematous cystitis. While quantitative urine culture via pyelocentesis yielded a negative culture, a sample via cystocentesis was positive for Escherichia coli and emphysematous changes were presumed most likely secondary to an ascending infection. The purpose of this report is to describe the temporary management of ureteral obstruction secondary to emphysematous pyelonephritis using a ureteral stent in a cat.