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Topic:Bronchoalveolar Lavage
Bronchoalveolar lavage (BAL) is a diagnostic procedure used to collect samples from the lower respiratory tract of horses. The technique involves the introduction of a sterile fluid into the bronchi and alveoli, which is then retrieved for analysis. BAL is utilized to assess the cellular and microbiological composition of the lower airways, aiding in the diagnosis of respiratory conditions such as inflammatory airway disease, recurrent airway obstruction, and infections. The procedure provides valuable insights into the type and extent of inflammation or infection present in the respiratory system. This page compiles peer-reviewed research studies and scholarly articles that explore the methodology, applications, and clinical relevance of bronchoalveolar lavage in equine respiratory health.
Inflammatory phenotype and response to intradermal skin testing are not predictive of equine asthma diagnosis. The role of inflammation, allergy, and air quality in the pathogenesis of equine asthma has not yet been fully elucidated. Objective: To evaluate serum inflammatory cytokines, intradermal skin testing (IDT), and air quality in asthmatic horses. It was hypothesized that there would be an association between environmental allergies and poor air quality with asthma. Methods: 52 client-owned horses with clinical signs consistent with asthma were enrolled in this cross-sectional study. Horses were diagnosed with asthma based on the results of bronchoalveolar fluid (BALF) cytology. Blood samples wer...
Randomized study of the effects of testosterone administration on severity of asthma in horses. Low testosterone concentrations are associated with poor lung function in human asthmatics, and androgen administration improves airway obstruction in women with asthma. Objective: Testosterone improves clinical scores, lung function, airway neutrophilia, and airway remodeling in horses with severe asthma. Methods: Ten horses affected by severe asthma from a research herd. Methods: In a randomized, blinded, crossover study, horses received dexamethasone (0.06 mg/kg PO q24h for 10 days) or a single intramuscular injection of testosterone cypionate (0.35 mg/kg), with a 2-week washout period. ...
Ortholog-specific Spatial Expression of Vanins in the Respiratory Tract of Horses. Equine asthma (EA) is the most prevalent chronic respiratory disease in horses, but molecules thought to be relevant in its pathogenesis are not yet fully understood. Recently, increased Vanin-1 (VNN1) levels were found in bronchoalveolar lavage fluid from horses with severe EA. Human VNN1 is known as a pantetheinase, which is associated with respiratory diseases such as asthma, but the equine vanins (eVNNs) are uncharacterized. We identified the domain architecture of eVNN in silico and analyzed its tissue expression in healthy horses using RT-PCR (=5) and in situ hybridization (=3). Recombin...
Airway Lipid Mediators in Horses: Baseline Bronchoalveolar Lavage Fluid Profiles and Effects of EPA and DHA-rich Microalgae Oil Supplementation. We investigated how dietary omega-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) affect airway inflammation, bronchoalveolar lavage fluid (BALF) lipid mediators and red blood cell fatty acids in horses. Increased BALF neutrophils are a hallmark of airway inflammation, commonly associated with equine asthma. The long-chain n-3 PUFAs EPA and DHA are essential nutrients and precursors of specialized pro-resolving mediators (SPMs) that regulate inflammatory responses. In this prospective field trial, we assigned horses to three diets, including...
Circulating Cell-Free RNA Reflects Immune-Associated and Airway Remodeling Signatures in Equine Asthma. Circulating cell-free RNA (cfRNA) has emerged as a promising minimally invasive biomarker capable of capturing transcripts originating from multiple tissues and cell types, but its utility in chronic inflammatory airway diseases remains poorly understood. Equine asthma (EA), a naturally occurring respiratory disease that shares key clinical and immunopathological features with human asthma, provides a valuable comparative model for evaluating plasma cfRNA in this context. We performed transcriptomic profiling of plasma cfRNA from horses with EA and healthy controls and compared these findings ...
Effects of Nebulized Alpha-2 Macroglobulin in Horses with Lower Airway Inflammation. Equine asthma is a chronic inflammatory airway disease with limited safe long-term treatments. Alpha-2-macroglobulin (A2M), a natural anti-inflammatory protease inhibitor, may provide a novel non-steroidal therapeutic option for horses with lower respiratory tract inflammation. Objective: To characterize the impact of nebulization with alpha-2-macroglobulin (A2M) on clinical signs, bronchoalveolar lavage cytology, and local and systemic cytokine response in horses with lower respiratory tract inflammation. Methods: Thirteen university-owned horses with lower airway inflammation were randomized...
Cell-Type Deconvolution of Equine BALF RNA-Seq: A Critical Comparison with Matched Single-Cell Data. Bulk RNA sequencing (RNA-seq) averages signals across heterogeneous cell populations. Computational deconvolution methods aim to infer cell type composition and cell type-specific gene expression from bulk data, but their performance in equine samples has not been evaluated. In this study, we assessed the ability of computational deconvolution to recover cellular composition and differential expression signals in bronchoalveolar lavage fluid (BALF) from horses with severe equine asthma (SEA) and controls (CTL). Cryopreserved BALF samples from six SEA and five CTL horses previously analyzed b...
Inhaled Corticosteroids Influence Pulmonary Microbiota in Severe Equine Asthma. The use of inhaled corticosteroids (ICs) could influence the respiratory microbiota. In animals with asthma it is, however, difficult to separate the immunomodulatory effects of ICs from their indirect effects via improvement of ventilation. Our objective was to determine if ICs alter the pulmonary microbiota independently from their effects on lung function, using a blinded, controlled trial in an experimental model of asthma exacerbation in horses. We treated horses with severe asthma with either bronchodilators alone, or in combination with ICs. Twelve horses in exacerbation received long-a...
Biomarkers of equine asthma: A review of the current literature. Equine Asthma (EA) is a common, lower airway disease. Yet current diagnostic standards rely on bronchoalveolar lavage fluid (BALF) cytology, which is moderately invasive and not always feasible in field conditions. This review aimed to synthesize current evidence on candidate biomarkers of EA, with a primary focus on blood-based matrices and BALF, while also including data on biomarkers measured in tracheal wash (TW), saliva and exhaled breath condensate (EBC), where available. Searches were performed in PubMed, Scopus and Google Scholar, and original studies in horses with mild-to-moderate or...
The effects of upper airway obstruction on oxygen consumption and ventilatory variables in Colombian criollo horses. While conditions associated with upper airway obstruction (UAO) are reported in Colombian Criollo horses, their effect on ventilation and performance is unknown. Objective: To investigate how oxygen consumption ($dot{rm V}$O2), ventilation,, and exercise-induced pulmonary hemorrhage (EIPH) are affected by UAO in horses performing at natural gaits. Methods: Twenty-three client-owned Colombian Criollo horses. Methods: A cross-sectional observational study assigned horses to a control (C), or UAO group after overground endoscopy. All horses performed a standardized submaximal exercise test while ...
Bronchoalveolar lavage changes the ultrasonographic and radiographic appearances of lungs in adult horses. To describe the effect of bronchoalveolar lavage (BAL) on the ultrasonographic and radiographic appearances of lungs of horses being evaluated for equine asthma syndrome (EAS). Unassigned: Prospective observational study enrolling 32 adult horses evaluated for EAS. Ultrasonographic and radiographic examinations of the thorax were performed before and within 3 hours following BAL and scored using previously validated systems. The differences in scores between groups (normal, mild EAS, moderate/severe EAS) were evaluated through the Kruskal-Wallis test, and the differences in scores before and f...
Oral docosahexaenoic acid supplementation alters alveolar macrophage metabolism and protein and lipid profiles in the lower airway of healthy horses. To determine the impact of a commercially available docosahexaeonic acid (DHA) supplement (DHA, methylslfonylmethane, and mushroom blend) on equine alveolar macrophage metabolism and lipid and protein profiles in bronchoalveolar lavage (BAL) supernatant. Unassigned: This was a prospective, sequential, placebo-controlled study using 10 healthy adult horses. Bronchoalveolar lavage fluid was collected at baseline, following 45 days of oral placebo administration, and following 45 days of oral commercially available DHA supplement, with a 14-day washout. Whole blood was collected following placebo...
The transition from winter to spring has an impact on the airway metabolome profile of asthmatic horses. Equine asthma is a chronic, non-infectious inflammatory disease of the lower airways in horses, classified as mild to moderate (MEA) or severe (SEA). Its pathogenesis is not fully understood and is influenced by environmental and seasonal factors. In this cross-sectional study, seasonal effects on the bronchoalveolar lavage fluid (BALF) metabolome were investigated in asthmatic and non-asthmatic horses. The metabolome of 230 BALF samples from horses across different seasons, classified as cytologically unremarkable (CUA), MEA, or SEA, was analyzed using proton nuclear magnetic resonance spectr...
Tracheal wash culture is not associated with bronchial infection, remodelling or inflammation in horses with asthma. Antimicrobials are commonly prescribed for the treatment of equine asthma, despite limited evidence supporting their use. Tracheal wash (TW) bacterial culture results are known to influence antimicrobial prescription decisions. Objective: To determine whether a positive TW bacterial culture in horses with asthma is associated with bronchial infection or colonisation, increased bronchial remodelling and airway inflammation by evaluating the presence of bacteria and airway remodelling in endobronchial biopsies, as well as bronchoalveolar lavage fluid (BALF) cytology and tracheal mucus scores. Me...
Differences in Redox Biomarkers in Bronchoalveolar Lavage Fluid of Leisure Horses With and Without Severe Equine Asthma: Preliminary Results. Equine asthma is a common chronic respiratory disease characterized by airway inflammation and oxidative imbalance, particularly in its severe form. The aim of this study was to evaluate pro-oxidative substances, oxidative products, and antioxidant defense biomarkers in bronchoalveolar lavage fluid (BALF) from horses with and without a history of severe equine asthma (SEA). This prospective observational study included 21 leisure horses classified as SEA or non-SEA based on clinical history and BALF cytology. Bronchoalveolar lavage fluid was analyzed for derivatives of reactive oxygen metaboli...
A randomized, masked, crossover, clinical trial of the efficacy and safety of nebulized albuterol sulfate and dexamethasone sodium phosphate in asthmatic horses. Nebulization of injectable dexamethasone sodium phosphate (DSP; 0.01 mg/kg) to horses with severe equine asthma (SEA) was previously found to be ineffective. Horses with SEA have marked bronchoconstriction that decreases peripheral lung deposition of nebulized drugs. Administration of a bronchodilator immediately before nebulizing dexamethasone may improve efficacy. Objective: Evaluate the therapeutic effects and optimal dose of nebulized DSP after nebulized albuterol in horses with SEA. Methods: Seven horses with SEA from a research herd. Methods: In this masked randomized crossover trial, h...
An in-hospital clinical trial assessing nebulized lidocaine compared to saline for treatment of asthma in horses. Corticosteroids are the main pharmacologic treatment for equine asthma (EA) but may have adverse effects in metabolically unstable horses. Recent pilot studies support the use of nebulized lidocaine as an alternative treatment option. Objective: Nebulized lidocaine will improve EA-associated clinical variables and airway inflammation. Methods: Twenty client-owned horses diagnosed with EA. Methods: Randomized, blinded, in-hospital study comparing 1 mg/kg preservative-free 4% lidocaine (n = 10) nebulized via Flexineb (twice daily for 7 doses) to 0.9% saline control (n = 10). Clinical examin...
Multi-Kingdom Fecal Microbiota Alterations in Horses with Severe Equine Asthma. Severe equine asthma (SEA) is a chronic inflammation of airways affecting ~14-20% of adult horses in the Northern Hemisphere. SEA is characterized by a mixed phenotype of T helper cell responses with marked neutrophilia in the bronchoalveolar lavage fluid (BALF) of affected horses. Human studies have demonstrated the impact of gut microbiota in many diseases, including asthma susceptibility and severity. However, the potential role of the gut-lung axis in the development and persistence of SEA remains to be determined. This study aimed to identify key bacterial, archaeal, and fungal microbiota...
Proteomic profiling of equine airway mucus reveals compositional changes in asthmatic phenotypes. Mucus hypersecretion and accumulation are hallmark features of equine asthma (EA), a meaningful respiratory disorder in horses occurring in mild to moderate (MEA) and severe (SEA) forms. Changes of the proteomic composition of airway mucus in EA are poorly understood. Using label-free quantitative liquid chromatography-mass spectrometry, we analyzed airway mucus from SEA (n = 10), MEA (n = 6), and healthy (n = 8) horses. We identified and quantified 2,275 proteins including gel-forming mucins MUC5AC and MUC5B and membrane-bound mucins MUC1 and MUC4. Compared with healthy controls, ...
Genomic Epidemiology of Fungi Identified in Bronchoalveolar Lavage Fluid from Asthmatic Horses in the US. Fungal exposure is strongly implicated in the pathogenesis of asthma in horses, but the importance of specific fungi is unknown. Geographic variation in equine asthmatic endotypes is suspected and might be related to different fungal exposures due to different climatological and geographical conditions. This study had two objectives: evaluate the effect of the ecoregion upon BALF inflammatory cells and fungal community composition in horses with asthma and evaluate the effect of BALF fungal community composition upon the likelihood of neutrophilic, mastocytic and eosinophilic inflammation in t...
The trajectories of relative concentrations of antirhodococcal immunoglobulin A differ from those of immunoglobulin G subisotypes in bronchoalveolar lavage fluid but not serum of foals. To characterize age-related trajectories of the relative concentrations of anti-virulence-associated protein A (VapA) immunoglobulin (Ig)-G1, IgG3/5, IgG4/7, and IgA in serum and bronchoalveolar lavage fluid (BALF) as indicators of systemic and intrapulmonary immune responses in foals naturally exposed to Rhodococcus equi. Unassigned: Blood and BALF samples were collected at ages 4, 14, 28, and 56 days from healthy Quarter Horse foals (n = 19) naturally exposed to R equi. Samples were tested via ELISA for relative concentration of IgG1, IgG3/5, IgG4/7, and IgA recognizing the VapA of R equi. D...
A Portable Fluorometer Detects Significantly Elevated Cell-Free DNA in Tracheal Wash and Bronchoalveolar Lavage Fluid in Horses with Severe Asthma. Severe equine asthma (sEA) is characterized by increased lower airway neutrophils that contribute to dysregulated inflammation through the release of cytokines, reactive oxygen species and neutrophil extracellular traps (NETs). NETs are composed of cell-free DNA (cfDNA) intercalated with enzymatic proteins and are known to be increased in the lower airway of asthmatic horses. The objectives of this study were two-fold: 1. Determine if cfDNA can be accurately measured in equine bronchoalveolar lavage fluid (BALF) and tracheal wash (TW) with a Qubit 4 fluorometer. 2. Determine whether Qubit-meas...
Multi-pathogen lower respiratory tract infection including a fungal agent in a yearling mustang filly. This report describes the diagnosis and successful management of a yearling filly with Coombs-positive anemia, thrombocytopenia, and fungal pneumonia. Diagnostic procedures, including thoracic ultrasonography and radiography, respiratory pathogen PCR testing, and evaluation of tracheal wash and bronchoalveolar lavage samples established multi-pathogen lower respiratory tract infection including a fungal agent. Orally administered voriconazole was a key component of treatment in this case to successfully eliminate fungal infection, alongside therapies for managing hematologic disease. This case...
Equine Asthma Is Characterised by Severity-Dependent Correlations Between Blood Neutrophil Cholesterol Content and NET Formation. Equine asthma (EA) is the most prevalent chronic lung disease in horses. Neutrophils are the main effector cells in severe EA. Neutrophil extracellular traps (NETs) have been described as contributors to severity in human asthma and chronic obstructive pulmonary disease. Thus, we aimed to investigate if NET-related factors in equine neutrophils, blood and bronchoalveolar lavage fluid (BALF) allow us to differentiate EA severities and to identify NET-related mechanistic insights in EA. We quantified NETs and NET-related factors in the blood and BALF of eight healthy horses and 18 horses with di...
Intraday and Interday Evaluation of pH and Hydrogen Peroxide in the Exhaled Breath Condensate of Horses Using A Portable Device. The analysis of equine exhaled breath condensate (EBC) lacks standardized methodology, and current collection devices are often adapted for research. This study evaluates a novel horse-specific EBC collector and assesses the variability of EBC pH and hydrogen peroxide (HO) levels, exploring potential correlations with bronchoalveolar lavage (BAL) and tracheal wash (TW) cytology. Eleven healthy mixed-breed mares from a teaching herd, with no evidence of airway abnormalities, were included in this randomized observational study. The collection efficiency of the proposed device was assessed, and ...
Steamed hay for the prevention of severe equine asthma exacerbations. Steaming hay reduces respirable particles and is commonly used to feed horses with asthma. However, it showed inconsistent benefits in clinical studies. Objective: (1) To assess the effects of steamed hay on lung function and airway inflammation in horses with severe equine asthma (SEA) in remission; (2) To compare these effects with a dry hay diet. Methods: Cross-over in vivo experiment. Methods: Horses were fed steamed and dry hay for 4 weeks in a prospective, cross-over study, with a 4-week washout period. Lung function, bronchoalveolar lavage (BALF) cytology, and a 23-point weighted clin...
Effects of mixed polyphenol supplementation on lower airway inflammation in horses with Equine Asthma Syndrome. Equine Asthma Syndrome (EAS) is a chronic inflammatory respiratory disease of adult horses. While dietary polyphenols have shown anti-inflammatory effects in human asthma, their use in equine asthma has not been studied. Objective: To evaluate the effects of a mixed polyphenol supplement on systemic and pulmonary inflammation, bronchoalveolar lavage (BAL) cytology, and clinical respiratory signs in healthy and asthmatic horses. We hypothesized that polyphenol supplementation would decrease systemic and pulmonary inflammation in both healthy and asthmatic horses and would improve BAL cytology a...
Comparison Between Tracheal Wash and Bronchoalveolar Lavage Cytology for the Assessment of Airway Inflammation in Racehorses Affected by Exercise-Induced Pulmonary Hemorrhage. Exercise-Induced Pulmonary Hemorrhage (EIPH) results from alveolar capillary stress failure after strenuous exercise, leading to bleeding and pulmonary inflammation. Bronchoalveolar lavage fluid (BALF) cytology is considered the gold standard for the assessment of airway inflammation; however, it is often considered more invasive compared to tracheal wash (TW). It has been demonstrated that TW is a reliable diagnostic tool that may substitute BALF to diagnose and grade the severity of EIPH in racehorses; however, no information about airway inflammation in EIPH-affected horses has been reporte...
Influence of a Standardized Lunging Exercise Test on BALF Cytology in Horses Suffering from Mild-Moderate Equine Asthma. Mild-moderate equine asthma (MEA) is a very common but underdiagnosed pulmonary disease in horses, with mild cases not showing clinical respiratory signs. This study evaluates the influence of a standardized lunging exercise test (SLET) on bronchoalveolar lavage fluid (BALF) cytology in MEA horses. We hypothesized that SLET would increase the total nucleated cell count (TNCC) and/or percentages of inflammatory cells associated with EA. In a prospective, randomized, non-blinded, between-subjects study design of two independent groups, 39 horses (17 mild and 22 moderate) were included. They were...
Endoscopically assessed mucus parameters in equine asthma: Relationship to clinical history and cytological findings data. Mucus parameters are hallmark diagnostic features of equine asthma (EA). Objective: To investigate the relationship between mucus quantity score and mucus viscosity score with signalment, history, clinical findings and cytological parameters. Methods: Retrospective cross-sectional study. Methods: Mucus quantity and viscosity scores, signalment, history and clinical findings recorded for diagnostic purposes from up to 1599 samples, and cytological values of the corresponding bronchoalveolar lavage fluid (BALF) and tracheobronchial secretions were analysed. The cut-off value of a mucus quantity ...
