Porcine epidemic diarrhea virus reduces feed efficiency in nursery pigs.

Porcine epidemic diarrhea virus (PEDV) infects enterocytes and in nursery pigs, results in diarrhea, anorexia, and reduced performance. Therefore, the objective of this study was to determine how PEDV infection influenced growth performance and repartitioning of amino acids and energy in nursery pigs. A total of 32 barrows and gilts, approximately 1 wk post-wean (BW = 8.46 ± 0.50 kg), and naïve for PEDV were obtained, weighed, and allotted based on sex and BW to one of two treatments: 1) Control, PEDV naïve and 2) PEDV-inoculated (PEDV) with eight pens of two pigs each per treatment. On day post-inoculation (dpi) 0, PEDV pigs were inoculated via intragastric gavage with PEDV isolate (USA/Iowa/18984/2013). Pig and feeder weights were recorded at dpi -7, 0, 5, and 20 in order to calculate ADG, ADFI, and G:F. Eight pigs per treatment were euthanized on dpi 5 and 20, and tissues and blood were collected. At dpi 5, all PEDV pigs were PCR positive for PEDV in feces. Overall, PEDV pigs tended (P < 0.10) to increase ADFI, which resulted in reduced (P < 0.05) feed efficiency. At dpi 5, PEDV pigs had reduced (P < 0.05) villus height and increased (P < 0.05) stem cell proliferation in the jejunum compared with Control pigs. Pigs inoculated with PEDV had increased (P < 0.05) serum haptoglobin and increased insulin-to-glucose ratios compared with Control pigs at dpi 5. Markers of muscle proteolysis were not different (P > 0.05) between treatments within dpi; however, at dpi 5, 20S proteasome activity was increased (P < 0.05) in longissimus dorsi of PEDV pigs compared with Control pigs. Liver and jejunum gluconeogenic enzyme activities were not different (P > 0.05) between treatments within dpi. Overall, PEDV-inoculated pigs did recover the absorptive capacity that was reduced during PEDV infection by increasing proliferation of intestinal stem cells. However, the energy and nutrients needed to recover the epithelium may be originating from available luminal nutrients instead of muscle proteolysis and gluconeogenesis. This study provides insight into the effects of an enteric coronavirus on postabsorptive metabolism in nursery pigs.

Effects of porcine epidemic diarrhea virus infection on nursery pig intestinal function and barrier integrity.

The pig intestinal epithelium can be compromised by pathogens leading to reduced integrity and function. Porcine epidemic diarrhea virus (PEDV), recently detected in North America, exemplifies intestinal epithelial insult. Although several studies have investigated the molecular aspects and host immune response to PEDV, there are little data on the impact of PEDV on pig intestinal physiology. The objective of this study was to investigate the longitudinal impact of PEDV on nursery pig intestinal function and integrity. Fifty recently-weaned, 5-week-old barrows and gilts (BW=9.92±0.49kg) were sorted based on body weight (BW) and sex into two treatments: 1) Control or 2) PEDV inoculated. At 2, 5, 7, and 14days post inoculation (dpi), 4 pigs per treatment were euthanized and jejunum sections collected. PEDV antigen was detected in inoculated pigs by immunohistochemistry in 50% (2/4) at dpi 2, 100% (4/4) at dpi 5, and none at later time points. PEDV-infected pigs had reduced (P<0.05) villus height and decreased transepithelial resistance compared with controls. Total acidic mucins, particularly sialomucin, were reduced in PEDV pigs at dpi 2 and then increased compared with controls at dpi 7 and 14. In addition, PEDV pigs had increased stem cell proliferation (P<0.05) and a numerical increase in DNA fragmentation compared with controls through dpi 7 which coincided with an observed return of digestive function to that of controls. Collectively, these data reveal that PEDV infection results in time-dependent changes not only in intestinal morphology but also barrier integrity and function.

Nursery pig growth performance and tissue accretion modulation due to porcine epidemic diarrhea virus or porcine deltacoronavirus challenge.

Porcine epidemic diarrhea virus (PEDV) and porcine deltacoronavirus (PDCoV) are both members of the family which induce clinical signs of diarrhea, dehydration, and in some circumstances, mortality. Most research has been focused on isolation, genome sequencing, pathogenicity, and virulence of these viruses, but there is little information on long-term growth performance and tissue accretion of pigs inoculated with PEDV or PDCoV. Therefore, our objective was to determine the effect of PEDV or PDCoV infection on growth performance and tissue accretion over 42 d following inoculation. A total of 75 Choice Genetics Large White Pureline barrows and gilts (BW = 10.81 ± 0.81 kg) at approximately 2 wk post-wean and naïve for PEDV and PDCoV were selected. Pigs were allotted based on BW and sex, stratified across 3 treatments with 8 pens per treatment. Treatments were: 1) Control ( = 8); 2) PEDV inoculated ( = 8); and 3) PDCoV inoculated ( = 8). On day post inoculation (dpi) 2, 5, 7, and 14 pigs were euthanized for tissue collection and analyses from these tissues are discussed elsewhere. Pen feed intake and BW were recorded on dpi 2, 5, 7, and weekly thereafter until dpi 42. On 1 designated pig per pen, initial and final body composition was determined using dual-energy X-ray absorptiometry (DXA) and tissue accretion rates were calculated over 6 wk test period. Peak PEDV infection was noted at 3 dpi compared with 4 dpi for PDCoV pigs as determined by fecal swab quantitative real-time PCR (RT-PCR). Control pigs remained negative for PEDV and PDCoV throughout the experiment. Overall, Control and PDCoV pigs did not differ in ADG, ADFI or G:F ( > 0.05). Compared to Control and PDCoV pigs, the overall 42 d ADFI was reduced in the challenged PEDV pigs ( < 0.05) by 19 and 27%, respectively. PEDV did not significantly reduce the overall ADG or G:F compared with Control and PDCoV pigs; however, the biggest reduction in ADG and ADFI for PEDV pigs was within 14 dpi compared to the Control pigs ( < 0.05). Whole body tissue accretion was altered due to PED, with fat, lean, protein, and bone mineral accretion reductions by 24, 20, 21, and 42%, respectively ( < 0.05) compared with Control pigs. Overall, nursery pig performance was greatly impacted by PEDV challenge. Surprisingly, the PDCoV challenge did not negatively influence nursery pig performance. This study provides further insight into the longitudinal impact swine enteric coronaviruses have on growing pigs.

Actuarial outcome after catheter balloon commissurotomy in patients with mitral stenosis.

BACKGROUND: The goal of the present study was to determine the intermediate-term survival and the independent predictors of survival and event-free survival for patients who undergo catheter balloon commissurotomy (CBC). METHODS AND RESULTS: CBC for the treatment of mitral stenosis was performed in 132 patients from 1986 through 1994. The use of CBC increased the mitral valve area (MVA) from 1.0 +/- 0.3 to 1.9 +/- 0.6 cm2 (P < .001). There were six early deaths (4.5%) up to 1 month after CBC ("hospital" deaths). In the past 4.5 years, there have been no hospital deaths. Four late deaths occurred after elective mitral valve replacement (MVR). Actuarial 7-year survival was 95 +/- 1%; when mortality after MVR is included, 7-year survival was 83 +/- 6%. Actuarial 1-, 3-, 5-, and 7-year event-free survival (survival without MVR or repeat CBC) was 80 +/- 4%, 77 +/- 4%, 65 +/- 6%, and 65 +/- 6%. On multivariate analysis, the only two independent predictors (both after CBC) of 7-year event-free survival were MVA of > or = 1.5 versus < 1.5 cm2 (75 +/- 7% versus 32 +/- 12%) and mean pulmonary artery wedge pressure of < or = 18 versus > 18 mm Hg (84 +/- 6% versus 38 +/- 11%) (P < .001 for both). Patients with MVA of > or = 1.5 cm2 (n = 96) could be further subdivided into high- and low-risk subgroups for 7-year event-free survival by two post-CBC variables: mean pulmonary artery wedge pressure of < or = 18 versus > 18 mm Hg (90 +/- 6% versus 48 +/- 14%) (P = .0002) and cardiac index of > or = 2.5 versus < 2.5 L.min-1.m-2 (82 +/- 8% versus 61 +/- 13%) (P = .004). Patients with post-CBC MVA of < 1.5 cm2 (n = 24) had no additional predictors of event-free survival. Of patients who did not undergo MVR or repeat CBC, 8% were in New York Heart Association functional class III and 92% were in class I or early class II at the last follow-up. CONCLUSIONS: The rates for intermediate-term survival and event-free survival after CBC are very encouraging. Most patients without events were asymptomatic or minimally symptomatic. Thus, in selected patients with mitral stenosis who require an interventional procedure, CBC is the procedure of choice at centers with physicians who have experience and skill in performing this procedure.