Acquired equine polyneuropathy of Nordic horses: A conspicuous inclusion body schwannopathy.

Acquired equine polyneuropathy (AEP), formerly also known as Scandinavian knuckling syndrome, is one of the most prevalent polyneuropathies in equids in Norway and Sweden, with more than 400 cases registered since first observations in 1995. Despite geographical clustering and an association to forage feeding, its aetiology remains unknown. Clinically AEP is characterized by knuckling due to dysfunction of metatarsophalangeal extensor muscles. This neuropathological study aimed to gain further insights in the pathobiology of AEP and its underlying aetiopathogenesis. We thereby confirmed that all affected horses suffered from similar large fibre neuropathy, exhibiting conspicuous Schwann cell inclusions in most samples, suggestive of a primary disruption of Schwann cell metabolism leading to inclusion body schwannopathy with secondary inflammatory changes. The degree of nerve pathology was not predictive of clinical outcome.

Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.

REASONS FOR PERFORMING STUDY: Hypoglycin A (HG) appears to cause atypical myopathy (AM), but to our knowledge, detection of HG in affected and unaffected horses and concurrently in plants that they were exposed to has not previously been reported. OBJECTIVES: To investigate HG in samples from horses exposed to Acer pseudoplatanus (European sycamore maple) and in such plant material, at the time of clinical cases of AM in the herd. STUDY DESIGN: Cross-sectional study. METHODS: Blood was collected from 2 horses with AM and 22 clinically healthy co-grazing horses in 2 Swedish farms within one week of onset of signs (May 2014) and one month later, after horses were moved to other pastures. Ten healthy control horses from unaffected farms were sampled once. Samaras, seedlings, flowers and leaves from Acer pseudoplatanus and from Acer platanoides L (Norway maple) were collected from affected pastures. Hypoglycin A was analysed using chemical derivatisation with dansyl chloride (DNS) and ultra high performance liquid chromatography-tandem mass spectrometry. Hypoglycin A was detected as derivatised compound HG-DNS [M+H]+ with selected reaction monitoring. RESULTS: Hypoglycin A was detected in the horses affected with AM, and also in 20 out of 22 co-grazing horses. One month later, a surviving case horse and 9/20 co-grazing horses were still positive for HG. Controls from other farms were negative for HG. Hypoglycin A was detected in plant material from Acer pseudoplatanus, but not from Acer platanoides L. CONCLUSIONS: Horses grazing in pastures with HG-containing Acer pseudoplatanus were positive for HG in blood, and some showed severe signs of myopathy. Ethical animal research: Ethical consent for blood sampling was granted (C113/11) and horse owners gave their informed consent to inclusion of horses in the study. SOURCE OF FUNDING: National Veterinary Institute, Sweden. Competing interests: None declared.

Acquired equine polyneuropathy in Norway and Sweden: a clinical and epidemiological study.

REASONS FOR PERFORMING STUDY: Acquired equine polyneuropathy (AEP, also known as 'Scandinavian knuckling syndrome'), is a serious disease of unknown aetiology, which emerged clustering in horse farms in Sweden, Norway and Finland in the 1990s. Clinical and epidemiological data regarding the syndrome are scarce. OBJECTIVES: To describe the clinical and epidemiological findings and outcome in outbreaks of AEP and compare risk factors in affected and unaffected horses on affected farms in Norway and Sweden during 2007-2009. METHODS: Neurological examinations were performed and data collected regarding demography, usage, turning-out, feeding, prophylactic strategies and long-term outcome. RESULTS: Thirteen affected farms with 157 horses of various breeds, of which 42 were AEP cases, were studied. Typical digital extensor dysfunction and knuckling of pelvic limbs were noted in 34 definitive cases. Eight additional plausible cases had a severe, acute course of neurological disease. There were no signs of brain orcranial nerve dysfunction. Cases occurred from December to April, with new cases emerging within 100 days of the index case. Affected and unaffected horses were fed wrapped forage. Prevalence for AEP was 27% and case fatality 29%. The median duration of AEP in survivors was 4.4 months (1-17 months). Survivors returned to full work within 19 months (median 6.6 months). Acquired equine polyneuropathy was less prevalent in horses aged > 12 years and young horses had a higher chance of survival than older horses. Management factors did not differ between affected and unaffected horses. CONCLUSIONS: Acquired equine polyneuropathy is a potentially fatal neurological disease characterised by pelvic limb knuckling. Surviving horses returned to normal function after a long period of rest. Cases were clustered in farms during the winter/spring season. Wrapped forage was used in all farms. POTENTIAL RELEVANCE: The results provide valuable insights into the dinical examination, handling and prognosis of cases of AEP, an emerging neurological disease of unknown aetiology in horses.

Opsonization of yeast cells with equine iC3b, C3b, and IgG.

The main opsonins in serum are antibodies and complement factor C3. The opsonization mechanisms including complement activation and deposition are important in studies of phagocytosis and of mechanisms of microbial immune evasion. The objective of the present study was to monitor the deposition of complement C3 and IgG from equine serum on yeast cells (Saccharomyces cerevisiae) using a flow cytometric immunoassay. Correlations were made between the opsonic coating and phagocytic capacity using equine blood neutrophils. In addition, the bound C3 fragments were characterized by SDS-PAGE and Western blot analyses. Opsonic coating of yeast with equine C3 and IgG occurred rapidly with detectable levels with as little as 0.75% serum. C3 deposition was a result of complement activation and no passive adsorption was observed. When complement was inactivated, the fluorescence indicating IgG deposition increased 3-6-fold, indicating spatial competition between C3 and IgG at binding. Opsonization with 1.5% serum led to suboptimal equine neutrophil phagocytosis of yeast cells which was dependent on complement activation by the classical pathway. With > or =6.25% serum, IgG contributed to opsonization and phagocytosis. With 50% serum and more, C3 was deposited also by the alternative pathway. Phagocytosis rates became optimal with 3% serum, and did not increase further with higher serum concentrations. The main form of C3 on the yeast cells was iC3b and the rest was C3b without any detectable breakdown products (C3c or C3dg). The equine complement components are similar in size to the human equivalents. It may be concluded that opsonization of yeast particles leading to phagocytosis, occurs at very low serum concentrations (1.5%) and that it is dependent on activation of the classical complement pathway at this low opsonic level. This is an important finding for efficient host defense, e.g. extravascular phagocytosis at infection sites.

Opsonic capacity of foal serum for the two neonatal pathogens Escherichia coli and Actinobacillus equuli.

Two of the most commonly isolated foal pathogens are Escherichia coli and Actinobacillus equuli. The hypothesis tested in this study was that young foals carry a lower opsonic capacity for these bacteria compared to adult horses. A flow-cytometric method for the phagocytosis of these by equine neutrophils was established. The opsonic capacity of serum from healthy foals from birth to age 6 weeks was evaluated and related to the concentrations of IgGa and IgGb. Phagocytosis of yeast was used as a control. Serum was required for phagocytosis, with higher concentrations for E. coli than for A. equuli. Ingestion of colostrum led to a significantly higher serum opsonic capacity. After that, there was no consistent age-related trend for opsonic capacity for the different microbes. Foal serum showed similar or higher opsonisation of E. coli and A. equuli compared to serum from mature individuals. During the studied period, the predominance among IgG subisotypes switched from IgGb to IgGa. Although the overall correlation between concentrations of IgG subisotypes and serum opsonic capacity was poor, sera with IgGb levels below 1.9 mg/ml induced lower opsonisation of E. coli and yeast, but not of A. equuli. Complement activation was important for opsonisation of all tested microbes. The results of this study are significant to the understanding of a key immunological facet in the pathophysiology of equine neonatal septicaemia in clinical practice.

Neutrophil functions and serum IgG in growing foals.

The aim of this study was to investigate the phagocytic and killing capacities as well as expression of CD18 of neutrophils obtained from healthy foals from birth to age 8 months. Blood was taken from 6 Standardbred foals at 7 time-points between ages 2-56 days and thereafter once a month. For comparison, cells from 16 mature horses were evaluated. Neutrophil phagocytosis of yeast cells was assessed by flow cytometry after opsonisation with mature pooled serum, autologous serum or anti-yeast IgG. The killing capacity of the neutrophils, as indicated by the oxidative burst, was monitored by chemiluminescence. Serum IgG concentration was measured by radial immunodiffusion. In addition to clinical examination, the amount of serum amyloid A and the total leucocyte count were used as markers for infection. The phagocytic ability was impaired until age 3 weeks, when autologous serum was used as opsonin. Killing capacity was also low initially but, from 3 months onwards, chemiluminescence values were equal to or higher than in mature horses. Serum IgG decreased from 10 g/l at 2 days to 5 g/l at 2 months and then increased gradually to 10 g/l at the end of the study. These findings may in part explain the increased susceptibility to bacterial infections in young horses.

Influence of age and plasma treatment on neutrophil phagocytosis and CD18 expression in foals.

The aim of this study was to evaluate the influence of age and plasma treatment on neutrophil phagocytosis, CD18 expression and serum opsonic capacity in foals in field settings. Microbial infections constitute a large threat in young foals and neutrophil functions are crucial for the defense. Blood samples were obtained from 13 foals at seven time points between the ages of 2 and 56 days and once from 16 adult horses. Six of the foals were treated with adult plasma at the age of 1 week. Neutrophil phagocytosis of yeast after various opsonizations and the expression of complement adhesion receptor CD18 were analysed by flow cytometry. Autologous serum opsonization resulted in 52+/-6.1% phagocytic neutrophils in 2-day-old foals (n = 12), a significantly lower rate than in adult horses (mean 84+/-3.1%; n = 16). In foals, yeast ingestion per neutrophil was also lower than in adults. Opsonic capacity increased with age (p < 0.05), reaching adult levels at 3-4 weeks. An increase in serum opsonic capacity followed plasma treatment (p < 0.05). The phagocytic capacity of foal neutrophils at the time-points studied was equal to or higher than that in the adults, when pooled adult horse serum or anti-yeast IgG was used as opsonin. In foals, serum IgG concentration was negatively correlated to serum opsonic capacity. CD18 receptor expression was higher in neutrophils from foals (<21 days old) than in those from adult horses (p < 0.05). The results indicate that foals are transiently deficient in serum opsonic capacity, which negatively affects their capacity for neutrophil phagocytosis. These changes in serum opsonins, unrelated to IgG, may be important factors in susceptibility to infections in foals.

The effects of an endurance ride on metabolism and neutrophil function.

The effects of an endurance ride on neutrophil functions in endurance-trained horses were evaluated and related to metabolic changes and changes in cortisol concentrations. Blood samples were taken from 7 horses (aged 9-15 years) one day before, and then 30-60 min, 1 day and 8 days after the ride. The race resulted in elevated serum cortisol levels (< 465 nmol/l) and an increased neutrophil:lymphocyte ratio. Immediately post race, the neutrophil ability to engulf yeast was increased. One day after the race, a decrease in leukotriene B4 production (approximately 40%) and in the respiratory burst (approximately 75%) was observed. Blood glucose concentration remained unchanged, as did serum lactate, which was low. After the race, the muscle glycogen stores were about 33% of the values noted after 8 days of recovery. Histochemical staining showed that 22 +/- 2% of the muscle fibres were totally depleted of glycogen. CK activity increased significantly from 40 +/- 10 mmol/min pre-race to 228 +/- 38 mmol/min post race. It was concluded that both hormonal and metabolic changes occurred during an endurance ride, which not only triggered neutrophil activation, but also induced alterations in their functional capacities.

Opsonic effect of equine plasma from different donors.

The ability of equine plasma from different donors to enhance phagocytic capacity was assessed in neutrophils obtained from seven foals, aged 7-8 days (Study A), and from seven adult horses (Study B). Neutrophils were allowed to phagocytize fluorescent yeast cells opsonized with plasma from one of three donors or with pooled serum, all previously frozen (-18 degrees C) and thawed. The results were analysed by flow cytometry. In study A, fresh autologous foal serum was also used for opsonization, and in study B, heat-inactivated plasma and pooled serum were used in addition to untreated samples. The plasma from donor GN induced a higher number of truly phagocytic neutrophils (mean 78%) than did plasma from donors GD (68%), OD (66%) and pooled serum (59%) when neutrophils from foals were used (p < 0.05). Similar results were obtained when adult neutrophils were used. Phagocytosis was markedly reduced with beat-inactivated plasma as a result of there being fewer phagocytic neutrophils and less phagocytized material per cell. The opsonic capacities of the autologous foal sera were lower than that of adult donor plasma in six out of seven foals. It is concluded that there is significant individual variation in the opsonic activity amongst plasma donors with similar serum IgG concentrations. The results were consistent irrespective of whether neutrophils from adults or foals were used.

Patients' experiences of herpes zoster and postherpetic neuralgia.

The purpose of the study was to investigate retrospectively whether patients (n = 73) who had suffered another disease and/or experienced psychosocial stress at the time of the onset of herpes zoster had experienced a more severe clinical course of herpes zoster, and were more subject to the development of postherpetic neuralgia than other patients (n = 45) with herpes zoster. The interview questionnaire included questions about changes in the patients' daily lives due to neuralgia, and their current living circumstances. Significantly more of the patients who had had another disease and/or psychosocial stress at the time of the onset of herpes zoster reported severe pain during the acute phase of herpes zoster. They also reported pain to a greater extent at the time of the interview and mentioned that their lives had changed owing to postherpetic neuralgia. More of these patients reported that their habits and activities had been negatively affected and they also experienced their current situation as unsatisfactory. These results must, however, be interpreted with caution as the patients' recollection of other diseases and/or psychosocial stress and the patients' current mood due to postherpetic neuralgia at the time of the interview may have influenced the memory and the answers.

Flow-cytometric studies of the phagocytic capacities of equine neutrophils.

Methodological aspects of flow-cytometric evaluation of the phagocytic properties of equine neutrophils were elucidated. The kinetics of attachment and ingestion were studied, and the phagocytic process was more rapidly completed when serum-opsonized yeast cells were used than with use of IgG-opsonized yeast cells. Trypan blue was successfully used to quench fluorescence of non-ingested yeast cells. There were only minor differences in the kinetics of phagocytosis between quenched and unquenched samples, indicating that attachment is rapidly followed by ingestion. Trypan blue quenching caused loss of cells with light scattering properties of granulocytes, although this did not affect the determined frequencies of truly phagocytic neutrophils. Aggregation of yeast cells proved to be a disturbance but not an obstacle to the determination of frequencies of actively phagocytic cells. Flow cytometry is well suited for studies of phagocytosis of yeast cells by equine neutrophils, and the trypan blue quenching provides a means of eliminating false-positive events due to aggregation of yeast cells. The main advantage of the flow-cytometric method is the possibility of rapid processing of a large number of samples, making the method useful for studies of herds.