Bronchoalveolar lavage fluid neutrophilia is associated with the severity of pulmonary lesions during equine asthma exacerbations.

BACKGROUND: The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. OBJECTIVE: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia. STUDY DESIGN: Observational retrospective study. METHODS: Peripheral lung tissues, BALF cytology and lung function data from 61 horses (22 controls, 24 asthma exacerbations and 15 asthma remission) were obtained from an equine pulmonary tissue bank. Two pathologists semi-quantitatively assessed histological features, including airway wall inflammation, interstitial fibrosis, mucus cell hyperplasia, mucostasis, peribronchiolar metaplasia, presence of granuloma and the overall severity of these lesions. RESULTS: Mucostasis, mucus cell hyperplasia, peribronchiolar metaplasia and interstitial fibrosis were associated with disease exacerbation (P≤0.05), and these changes were all attenuated during remission. Airway wall inflammation was greater in horses with asthma in exacerbation compared with horses with asthma in remission and control horses (P≤0.05). Acute (neutrophilic) airway wall inflammation was more frequently detected in asthmatic cases compared with control horses (P<0.0001) and was associated with BALF neutrophilia >5% in control horses (P = 0.002). The degree of bronchiolar inflammation was higher in asthmatic horses in remission stabled and treated pharmacologically compared with those kept on pasture (P = 0.04). MAIN LIMITATIONS: Samples obtained from a convenient cohort of horses were studied. CONCLUSIONS: Severely asthmatic horses present parenchymal and peribronchial/peribronchiolar lesions possibly contributing to the obstructive nature of the disease.

Development of a Semiquantitative Histological Score for the Diagnosis of Heaves Using Endobronchial Biopsy Specimens in Horses.

BACKGROUND: Remodeling of the peripheral airways persists during the asymptomatic phase of heaves. Assessing the histology of large bronchi could facilitate the diagnosis of heaves during remission of the disease. HYPOTHESIS: Airway inflammation and remodeling in endobronchial biopsy (EBB) specimens differentiate horses with heaves from controls, independently of their clinical status (exacerbation or remission). ANIMALS: Fourteen healthy horses and 24 horses with heaves. METHODS: A 14-point scoring system assessing central bronchial wall inflammation and remodeling was developed. The score was validated by 2 pathologists using specimens obtained from 18 horses (6 controls, 6 with heaves exacerbation, and 6 with heaves remission) in which lung function had been assessed with impulse oscillometry. Clinical and research application of the score was evaluated using biopsy specimens obtained from 20 additional horses (8 controls, 6 with heaves exacerbation, and 6 with heaves remission). RESULTS: The score was repeatable (interclass correlation coefficient = 69%). It differentiated horses with heaves in exacerbation (mean ± SD: 6.2 ± 2.2) from those in remission (4.0 ± 1.0) and controls (3.6 ± 1.7, P < 0.0001). The histological scores of horses with heaves correlated with the ratio of respiratory resistance (R) at 5 and 10 Hz (R5 : R10 ratio, r = 0.65, P = 0.03), a parameter assessing airway obstruction. CONCLUSIONS AND CLINICAL SIGNIFICANCE: The proposed histological scoring system correlates with the degree of airway obstruction measured by impulse oscillometry. However, it does not discriminate horses with heaves in remission from controls. Evaluation of EBB specimens might be considered in future research and clinical studies of respiratory diseases in horses.

Inflammatory stimuli differentially modulate the transcription of paracrine signaling molecules of equine bone marrow multipotent mesenchymal stromal cells.

OBJECTIVE: Osteoarthritis (OA) is a degenerative disease of joint tissues that causes articular cartilage erosion, osteophytosis and loss of function due to pain. Inflammation and inflammatory cytokines in synovial fluid (SF) contribute to OA progression. Intra-articular (IA) injections of multipotent mesenchymal stromal cells (MSCs) are employed to treat OA in both humans and animals. MSCs secrete paracrine pro-inflammatory and anabolic signaling molecules that promote tissue repair. The objective of this study was to investigate the effects of OASF on the gene expression of paracrine signaling molecules by MSCs. METHODS: The effects of Lipopolysaccharide (LPS) and interleukin (IL)-1ß as well as both normal (N) and osteoarthritis (OA) SF stimulations on the expression of paracrine pro-inflammatory (tumor necrosis factor (TNF)-α, IL-1ß, IL-8), modulatory (IL-6) and anabolic (vascular endothelial growth factor (VEGF), transforming growth factor (TGF)-ß1 and insulin-like growth factor (IGF)-1) signaling molecules by equine bone marrow multipotent mesenchymal stromal cells (eBM-MSCs) was investigated employing reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: In contrast with NSF, OASF significantly up-regulated the expression of VEGF in eBM-MSCs. Both NSF and OASF significantly down-regulated the expression of IL-1ß. LPS and IL-1ß significantly increased the expression of pro-inflammatory cytokines (TNF-α, IL-8 and IL-6; and IL-1ß and IL-8 respectively). DISCUSSION: We conclude that the transcription of paracrine signaling molecules in eBM-MSCs is modulated by SF. Furthermore, OA alters the properties of SF and the response of eBM-MSCs. Finally, the effects of LPS or IL-1ß stimulation are distinct to that observed following stimulations with OASF.

Bronchoalveolar lavage fluid cytology and cytokine messenger ribonucleic Acid expression of racehorses with exercise intolerance and lower airway inflammation.

BACKGROUND: There is limited information relating bronchoalveolar lavage (BAL) cytology and cytokine messenger ribonucleic acid (mRNA) expression in racehorses with inflammatory airway disease (IAD). HYPOTHESIS AND OBJECTIVE: We hypothesize that cytokine expression in BAL cells would correlate with cytology. Thus, we evaluated the mRNA expression of selected cytokines in BAL cells in racehorses with exercise intolerance and lower airway inflammation. ANIMALS: Thirty-one client-owned Standardbred racehorses with exercise intolerance. METHODS: Prospective, observational study. Cells were obtained by BAL, and mRNA expression of interleukin (IL)-1ß, IL-4, IL-8, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ was determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR). RESULTS: Nine horses had normal BAL cell differential cytology (Controls), while 22 horses had evidence of IAD based on BAL fluid cytology. Relative expressions of TNF-α/glyceraldehyde 3-phosphate dehydrogenase (GAPDH; 0.0092 ± 0.010 versus 0.0045 ± 0.005, P= .034), IL-4/GAPDH (0.001 ± 0.002 versus 0.0003 ± 0.0003, P= .029), and IFN-γ/GAPDH (0.0027 ± 0.003 versus 0.0009 ± 0.001, P= .028) were greater in horses with IAD compared with controls. Furthermore, IL-4/GAPDH (0.001 ± 0.002 versus 0.0002 ± 0.0003, P < .0001) and IFN-γ/GAPDH (0.003 ± 0.003 versus 0.001 ± 0.001, P= .002) mRNA expression was increased in horses with increased metachromatic cell counts compared with horses with normal metachromatic cell counts. Only the mRNA expression of IL-1ß/GAPDH (1.1 ± 0.7 versus 0.3 ± 0.3, P= .045) was increased with airway neutrophilia. CONCLUSIONS AND CLINICAL IMPORTANCE: Differences in gene expression were associated with the presence of IAD and with specific cell types present in airway secretions of Standardbred racehorses with poor performance. These findings suggest that different pathophysiological pathways are implicated in IAD.

Isolation of equine bone marrow-derived mesenchymal stem cells: a comparison between three protocols.

REASON FOR PERFORMING THE STUDY: There is a need to assess and standardise equine bone marrow (BM) mesenchymal stem cell (MSC) isolation protocols in order to permit valid comparisons between therapeutic trials at different sites. OBJECTIVE: To compare 3 protocols of equine BM MSC isolation: adherence to a plastic culture dish (Classic) and 2 gradient density separation protocols (Percoll and Ficoll). MATERIALS AND METHODS: BM aspirates were harvested from the sternum of 6 mares and MSCs isolated by all 3 protocols. The cell viability after isolation, MSC yield, number of MSCs attained after 14 days of culture and the functional characteristics (self-renewal (CFU) and multilineage differentiation capacity) were determined for all 3 protocols. RESULTS: The mean +/- s.d. MSC yield from the Percoll protocol was significantly higher (6.8 +/- 3.8%) than the Classic protocol (1.3 +/- 0.7%). The numbers of MSCs recovered after 14 days culture per 10 ml BM sample were 24.0 +/- 12.1, 14.6 +/- 9.5 and 4.1 +/- 2.5 x 10(6) for the Percoll, Ficoll and Classic protocols, respectively, significantly higher for the Percoll compared with the Classic protocol. Importantly, no significant difference in cell viability or in osteogenic or chondrogenic differentiation was identified between the protocols. At Passage 0, cells retrieved with the Ficoll protocol had lower self-renewal capacity when compared with the Classic protocol but there was no significant difference between protocols at Passage 1. There were no significant differences between the 3 protocols for the global frequencies of CFUs at Passage 0 or 1. CONCLUSIONS AND CLINICAL RELEVANCE: These data suggest that the Percoll gradient density separation protocol was the best in terms of MSC yield and self-renewal potential of the MSCs retrieved and that MSCs retrieved with the Ficoll protocol had the lowest self-renewal but only at passage 0. Then, the 3 protocols were equivalent. However, the Percoll protocol should be considered for equine MSC isolation to minimise culture time.

Cholinergic stimulation attenuates the IL-4 induced expression of E-selectin and vascular endothelial growth factor by equine pulmonary artery endothelial cells.

The endothelium plays a critical role in regulating leukocyte recruitment and migration during inflammation. Recent studies provide evidence that acetylcholine (ACh) and other cholinergic mediators block endothelial cells activation and leukocyte recruitment during inflammation. We thus postulated that the non-neuronal cholinergic system might modulate the recruitment of neutrophils during allergic pulmonary inflammation. In the present study, we examined the effects of cholinergic stimulation on the expression of neutrophil chemokines and adhesion molecules by endothelial cells stimulated by recombinant equine (re) IL-4. Using primary equine pulmonary artery endothelial cells culture and real-time RT-PCR method, we observed that ACh, nicotine, and muscarine inhibit the expression of E-selectin and vascular endothelial growth factor by endothelial cells stimulated by reIL-4. The expression of CXCL-8, a potent neutrophil chemotactic cytokine, remained unaffected however. These findings suggest that the cholinergic anti-inflammatory pathway may modulate pulmonary allergic inflammation and remodeling by the inhibition of selected adhesion molecules and growth factors.

Effects of a MAPK p38 inhibitor on lung function and airway inflammation in equine recurrent airway obstruction.

REASONS FOR PERFORMING STUDY: It has been suggested that many of the beneficial effects of corticosteroids are mediated through mitogen-activated protein kinase (MAPK) p38 inhibition. OBJECTIVE: To investigate the efficacy of the MAPK p38 inhibitor compound MRL-EQ1 to either prevent (Phase 1) or treat (Phase 2) recurrent airway obstruction (RAO) in horses. METHODS: MRL-EQ1 was administered i.v. at a dosage of 0.75-1.5 mg/kg bwt q. 12 h. In Phase 1, susceptible horses in clinical remission were divided into 2 groups (n = 5/group), based on historical values of respiratory mechanics. All horses were entered in the study in pairs (one control, one treated horse) and exposed to the same environmental challenge (stabling, mouldy hay and dusty conditions). The treatment group received MRL-EQ1 for 14 days while the control horses were untreated during the same period. In Phase 2, affected horses were ranked by severity of respiratory dysfunction and split randomly into either dexamethasone or MRL-EQ1 treatment groups (n = 5/group). Bronchoalveolar lavage fluid, respiratory mechanic measurements, MRL-EQ1 plasma concentration and tumour necrosis factor (TNF) whole blood activity were evaluated sequentially. RESULTS: In Phase 1, MRL-EQ1 did not prevent the occurrence of clinical signs and pulmonary inflammation. However, treatment was associated with a reduction in severity and a delay in the onset of signs and a reduction in pulmonary neutrophilia. In Phase 2, plasma concentrations achieved resulted in ex vivo suppression of lipopolysaccharide-induced TNF production in equine blood. MRL-EQ1 did not improve airway inflammation or lung function and was associated in a dose dependent manner with behavioural (depression, excitability) and blood changes (neutrophilia, increased serum muscle enzyme concentrations). CONCLUSIONS: Inhibition of p38 in the horse was partially effective in reducing clinical signs and airway inflammation when administered prior to, but not during clinical exacerbation in RAO. POTENTIAL RELEVANCE: Inhibitors of p38 MAPK with a better toxicity profile may be effective in the prevention or treatment of RAO.

Use of laparoscopic equipment to divide abdominal adhesions in a filly.

Exploratory laparoscopy of the right dorsal portion of the abdominal cavity was performed on a Standardbred filly because of signs of mild abdominal pain of 7 days' duration. On the basis of clinical examination, diagnosis was suppurative peritonitis, abdominal adhesions in the area of the right ovary, and right displacement and impaction of the pelvic flexure of the ascending colon. During laparoscopy, an abdominal adhesion between the right uterine horn, the cecum, and the pelvic flexure was identified. The abdominal adhesions were either stretched with laparoscopic forceps used as a probe or dissected bluntly with the tips of a pair of 10-mm laparoscopic Kelly forceps. Antibiotics were administered for 21 days after surgery. The horse fully recovered and raced 11 months after the surgery.

Phenotypic characterization of lymphocyte subpopulations in horses affected with chronic obstructive pulmonary disease and in normal controls.

The alterations in lymphocyte subsets in chronic obstructive pulmonary disease (COPD) in the horse were investigated by using monoclonal antibodies to identify CD3+, CD4+, CD8+, and surface immunoglobulin positive (sIg+) lymphocytes in peripheral blood, bronchoalveolar lavage fluid (BALF), and pulmonary biopsy frozen tissue sections. COPD-affected horses (n = 5) and normal controls (n = 5) were sampled prestabling and 14 days poststabling, at which time the COPD-affected horses wee exhibiting clinical signs of COPD. The peripheral blood absolute CD4+ lymphocyte count was significantly elevated in the COPD-affected horses pre- and poststabling. The CD4:CD8 ratio in peripheral blood of COPD-affect horses was unaffected by stabling, but the same ratio in the control horses was significantly decreased. These findings support a hypothesis of deficient regulation of a systemic immune response to indoor air in the COPD-affected horses. A large population of leukocytes in pulmonary biopsy immunohistochemical sections from both groups of horses appeared to be CD3+ CD4- CD8-, an uncommon phenotype in both the peripheral blood and BALF.

Review of 40 cases of lung abscesses in foals and adult horses.

A retrospective study of 40 horses with primary lung abscesses without pleuropneumonia showed that lung abscesses occurred predominantly in young horses, usually in foals aged < or = 6 months. Hyperfibrinogenaemia was present in all but 2 horses, and other common clinical and haematological findings were hyperthermia, tachycardia, polypnoea, and neutrophilic leucocytosis. The most common bacterial species isolated from transtracheal aspirates were Streptococcus zooepidemicus (20/34) and Rhodococcus equi (13/34). Most horses (23/27) discharged from the hospital were long term survivors. Of the 19 horses for which a follow up was available, 12 raced or performed the task for which they were intended. None of the indicators evaluated in this study could reliably predict the bacterial species involved or the outcome.

Effects of centrifugation and specimen preparation technique on bronchoalveolar lavage analysis in horses.

Bronchoalveolar lavages (BAL) were performed for 6 healthy horses and 8 horses with lower airway diseases (LAD). Total cell and differential counts were performed before and after centrifugation and resuspension of the BAL cells in a small volume of fluid; there was no difference in the total cell counts, but mast cell percentages were significantly (P < 0.05) lower, after centrifugation, in the LAD group. The two specimen preparation techniques compared were cytocentrifugation and centrifugation on microscope glass covers. For both groups of horses, lymphocyte percentages were significantly lower on cytocentrifuged specimens; there was also an increase in the other predominant cell type, i.e. macrophages in healthy horses and neutrophils in horses with LAD. Lymphocyte percentages in healthy horses were higher than those reported in previous studies, possibly because of a long-standing exposure to a high-dust environment. This study suggests that one centrifugation of the BAL fluid does not affect total cell counts, but may cause a decrease in mast cell percentage; cytocentrifugation is associated with a consistent decrease in lymphocyte percentage.

Cutaneous hemangiosarcoma with pulmonary metastasis in a horse.

A 6-year-old Thoroughbred mare had a 7-cm ulcerated mass on the cranial aspect of the left cervical area. Ultrasonography revealed the mass to be < 1 cm thick and composed of small lobules that were filled by material hypoechoic to the surrounding muscle tissues. Fine-needle aspiration of the mass yielded blood, and cytologic examination revealed a few epithelial cells with neoplastic changes. Thoracic radiography revealed an interstitial pattern with several disseminated nodules. A diagnosis of cutaneous hemangiosarcoma with pulmonary metastases was made. The diagnosis was confirmed at necropsy.

Infiltrative lipoma in a quarter horse.

A case of infiltrative lipoma in the left flank of a yearling Quarter Horse is described. Rectal palpation, percutaneous ultrasonographic examination, the marbled appearance and poor delineation from surrounding tissues strongly suggested an infiltrative lipoma. This was confirmed by histological examination. Infiltrative lipomas should be included in the differential diagnosis of soft masses located in equine muscle.

Hypertrophic osteopathy in three horses and a pony.

Hypertrophic osteopathy was diagnosed in 3 horses and in a pony, ranging in age from 8 to 21 years. There were 2 females, 1 sexually intact male, and 1 gelding. In 3 animals, hypertrophic osteopathy was associated with pulmonary abscesses, bronchogenic squamous cell carcinoma, and ovarian granulosa-cell tumor, respectively, and resulted in death or euthanasia. Duration of the condition ranged from 1 to 4 months. In 1 horse, hypertrophic osteopathy was believed to be secondary to pregnancy, and resolved following uncomplicated delivery of a live foal.

Septic arthritis in 15 standardbred racehorses after intra-articular injection.

Case histories, results of synovial fluid analyses, treatment regimens and outcome are described for 15 adult Standardbred horses with confirmed post-injection septic arthritis. Joint sepsis followed injection of corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anaesthetic. The median interval from injection to appearance of clinical signs was 2.5 days, and median interval from injection to referral was 9 days. The median initial synovial leucocyte count on admission was 57 x 10(9)/litre, but there was a wide range of values (18-258 x 10(9)/litre). The median synovial neutrophil percentage was 95% (77-99%). All bacterial isolates were Gram-positive cocci, 86% of which were staphylococci. All treated horses (12/15) initially received broad-spectrum parenteral antibiotic therapy, and the articulations of all horses except one were lavaged, either with non-surgical through-and-through techniques only (N = 3), or surgically with arthrotomy (N = 1) or arthroscopy (N = 7). The owners of all treated horses were contacted and racing records were consulted. Eleven of 12 horses returned to racing. Outcome was judged as either satisfactory (3/12) if the horse had returned to racing levels similar to or better than before treatment, or unsatisfactory (9/12) if the horse had poorer performance or could not return to racing. The 3 horses with satisfactory follow-up had been treated with arthroscopy and post-surgical closed suction drainage. The results of bacterial cultures suggest that the initial antimicrobial agents used should be effective against penicillin-resistant staphylococci.

Effect of head and neck position on respiratory mechanics in horses sedated with xylazine.

We studied the temporal changes in respiratory mechanics associated with xylazine administration (1.1 mg/kg of body weight, IV) in standing horses (experiment 1), and determined the effects of head and neck position (experiment 2) and atropine administration (experiment 3) on the observed changes. Thoroughbred geldings, 3 to 5 years old (5 in experiment 1, 4 in experiments 2 and 3) were used. Flow rates were obtained from a pneumotachograph and a differential transducer attached to a tight-fitting mask. Electronic integration of the flow signal gave tidal volume. Total pulmonary pressure (PL) was defined as the difference between esophageal pressure, measured with a balloon sealed to the end of a polyethylene catheter, and mask pressure. In experiment 3, a blunt cannula positioned in the dorsal third of the eighth or tenth intercostal space was used to estimate transpulmonary pressure. Lateral tracheal pressure was measured, using a polypropylene catheter inserted percutaneously in the midextrathoracic tracheal lumen. Upper and lower airway pressures were defined as the difference between mask pressure or transpulmonary pressure and lateral tracheal pressure, respectively. Five observations were made: (1) There was a significant (P less than 0.05) increase in PL from 10 to 40 minutes after administration of xylazine. (2) Although an overall agreement between head and neck position and PL was detected, the maximal PL value was not always obtained with lowest head and neck position. (3) Lower and upper airway resistance increased with low head carriage, with a greater increase in upper airway resistance resulting in a decrease in lower to total airway resistance ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

Urolithiasis in 68 horses.

Medical records of 68 horses with urolithiasis were examined. Calculi were in the bladder in 47 horses, urethra in 11 horses, kidneys in 15 horses, and ureter in two horses. They occurred at several sites in six horses. Common clinical signs included hematuria, altered micturition (pollakiuria, dysuria, urinary incontinence), and tenesmus. Weight loss, possibly attributable to chronic renal failure and colic, was associated more commonly with renal and ureteral calculi. Weight loss also occurred in 13% of horses with cystic calculi only. In male horses, most cystic calculi were removed by perineal (ischial) urethrotomy under epidural anesthesia. Although there were few surgical complications with urethrotomy, seven of 15 horses with follow-up suffered recurrent urolithiasis.