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Topic:Equine Protozoal Myeloencephalitis

Equine Protozoal Myeloencephalitis (EPM) is a neurological disease affecting horses, caused by the protozoan parasites Sarcocystis neurona or, less commonly, Neospora hughesi. The disease occurs when these parasites infect the central nervous system, leading to a range of neurological symptoms. Horses with EPM may exhibit signs such as ataxia, muscle weakness, and incoordination. Diagnosis can be challenging and typically involves a combination of clinical assessment, serological testing, and sometimes cerebrospinal fluid analysis. This page compiles peer-reviewed research studies and scholarly articles that explore the pathogenesis, diagnostic approaches, and management strategies for Equine Protozoal Myeloencephalitis in horses.
Antigen-specific antibodies in cerebrospinal fluid after intramuscular injection of ovalbumin in horses.
Journal of veterinary internal medicine    September 27, 2002   Volume 16, Issue 5 588-592 doi: 10.1892/0891-6640(2002)0162.3.co;2
Furr M.Eighteen normal horses were assigned to 1 of 3 treatment groups to investigate the effects of IM or intrathecal (IT) administration of ovalbumin on serum and cerebrospinal fluid (CSF) antibody production. Horses of group 1 were injected intramuscularly with ovalbumin and adjuvant, while horses in treatment groups 2 and 3 received ovalbumin intrathecally or intravenously, followed by IM injection as in group 1. Serum and CSF antibody titers were tested in group I every 30 days for 4 months, while serum and CSF were collected in group 2 and 3 horses at postvaccination day 60. Horses of group 1 (...
Clinical diagnosis of equine protozoal myeloencephalitis (EPM).
Journal of veterinary internal medicine    September 27, 2002   Volume 16, Issue 5 618-621 doi: 10.1892/0891-6640(2002)0162.3.co;2
Furr M, MacKay R, Granstrom D, Schott H, Andrews F.The research article is about the study and in-depth understanding of diagnosing equine protozoal myeloencephalitis (EPM), a disease that impacts horses’ neurological functions. Introduction The main focus of the research […]
Detection of antibodies against Sarcocystis neurona in cerebrospinal fluid from clinically normal neonatal foals.
Journal of the American Veterinary Medical Association    July 20, 2002   Volume 220, Issue 2 208-211 doi: 10.2460/javma.2002.220.208
Cook AG, Maxwell VB, Donaldson LL, Parker NA, Ward DL, Morrow JK.To determine whether antibodies against Sarcocystis neurona could be detected in CSF from clinically normal neonatal (2 to 7 days old) and young (2 to 3 months old) foals. Methods: Prospective study. Methods: 15 clinically normal neonatal Thoroughbred foals. Methods: Serum and CSF samples were obtained from foals at 2 to 7 days of age and tested for antibodies against S. neurona by means of western blotting. Serum samples from the mares were also tested for antibodies against S. neurona. Additional CSF and blood samples were obtained from 5 foals between 13 and 41 days after birth and between ...
Folate deficiency during treatment with orally administered folic acid, sulphadiazine and pyrimethamine in a horse with suspected equine protozoal myeloencephalitis (EPM).
Equine veterinary journal    July 11, 2002   Volume 34, Issue 3 311-316 doi: 10.2746/042516402776186128
Piercy RJ, Hinchcliff KW, Reed SM.No abstract available
Effect of sulfadiazine and pyrimethamine on selected physiologic and performance parameters in athletically conditioned thoroughbred horses during an incremental exercise stress test.
Veterinary therapeutics : research in applied veterinary medicine    June 7, 2002   Volume 3, Issue 1 49-63 
Colahan PT, Bailey JE, Johnson M, Rice BL, Chou CC, Cheeks JP, Jones GL, Yang M.Following the regimen used to treat equine protozoal myeloencephalitis, sulfadiazine (20 mg/kg) and pyrimethamine (1mg/kg) were administered orally once daily to 12 physically conditioned Thoroughbred horses for 4 consecutive days. The horses were randomly assigned to two test groups in a crossover design, with each horse serving as its own control. A stepwise exercise stress test was conducted to exhaustion. No effect on athletic performance was observed, and only marginal effects were noted in some hematologic and serochemical measurements, including decreased total white blood cell counts, ...
Reduced levels of nitric oxide metabolites in cerebrospinal fluid are associated with equine protozoal myeloencephalitis.
Clinical and diagnostic laboratory immunology    May 3, 2002   Volume 9, Issue 3 605-610 doi: 10.1128/cdli.9.3.605-610.2002
Njoku CJ, Saville WJ, Reed SM, Oglesbee MJ, Rajala-Schultz PJ, Stich RW.Equine protozoal myeloencephalitis (EPM) is a disease of horses that is primarily associated with infection with the apicomplexan Sarcocystis neurona. Infection with this parasite alone is not sufficient to induce the disease, and the mechanism of neuropathogenesis associated with EPM has not been reported. Nitric oxide (NO) functions as a neurotransmitter, a vasodilator, and an immune effector and is produced in response to several parasitic protozoa. The purpose of this work was to determine if the concentration of NO metabolites (NO(x)(-)) in the cerebrospinal fluid (CSF) is correlated with...
Characterization of monoclonal antibodies developed against Sarcocystis neurona.
Parasitology research    March 8, 2002   Volume 88, Issue 6 501-506 doi: 10.1007/s00436-002-0602-y
Marsh AE, Hyun C, Barr BC, Tindall R, Lakritz J.Equine protozoal myeloencephalitis (EPM), caused by a protozoal parasite infection of the central nervous system, is the most commonly diagnosed neurologic disease of horses in North America. In specific regions of the United States approximately 50% of the horse population is seropositive to Sarcocystis neurona. However, not all seropositive horses develop clinical signs. Detailed clinical examination, along with cerebrospinal fluid antibody evaluation are often used to diagnose EPM. Postmortem evaluation of the brain stem and spinal cord for histopathologic lesions compatible with nonsuppura...
Detection of Sarcocystis neurona antibodies in French horses with neurological signs.
International journal for parasitology    February 19, 2002   Volume 32, Issue 4 481-485 doi: 10.1016/s0020-7519(01)00370-8
Pitel PH, Pronost S, Gargala G, Anrioud D, Toquet MP, Foucher N, Collobert-Laugier C, Fortier G, Ballet JJ.No abstract available
Molecular characterisation of a major 29 kDa surface antigen of Sarcocystis neurona.
International journal for parasitology    January 29, 2002   Volume 32, Issue 2 217-225 doi: 10.1016/s0020-7519(01)00324-1
Ellison SP, Omara-Opyene AL, Yowell CA, Marsh AE, Dame JB.A gene encoding a major 29 kDa surface antigen from Sarcocystis neurona, the primary causative agent of equine protozoal myeloencephalitis (EPM), was cloned, sequenced, and expressed as a recombinant protein. A cDNA library was prepared in the expression vector lambda ZAP from polyA+mRNA isolated from S. neurona merozoites cultivated in vitro. Random sequencing of 96 clones identified a clone of an abundant transcript having a translated amino acid sequence with 30% identity to the 31-kDa surface antigen of Sarcocystis muris cyst merozoites. Southern blot analysis indicated that the correspond...
Lymphocyte responses and immunophenotypes in horses with Sarcocystis neurona infection.
Equine veterinary journal    January 5, 2002   Volume 33, Issue 7 726-729 doi: 10.2746/042516401776249255
Tornquist SJ, Boeder LJ, Mattson DE, Cebra CK, Bildfell RJ, Hamir AN.No abstract available
Transforming growth factor beta concentrations and interferon gamma responses in cerebrospinal fluid of horses with equine protozoal myeloencephalitis.
Equine veterinary journal    January 5, 2002   Volume 33, Issue 7 721-725 doi: 10.2746/042516401776249408
Furr M, Pontzer C.The following experiment was performed to test the hypothesis that transforming growth factor beta (TGF-beta) concentration varies in the cerebrospinal fluid and serum of horses with EPM and to determine if cerebrospinal fluid (CSF) alters the interferon-gamma (IFN-gamma) rersponse of equine peripheral blood mononuclear cells (PBMCs). The concentration of transforming growth factor-beta (TGF-beta2) was investigated in the serum and cerebrospinal fluid (CSF) of 18 horses (9 normal, 9 affected with equine protozoal myeloencephalitis [EPM]). The TGF-beta2 assay was validated in a group of 6 norma...
Risk factors associated with the presence of Sarcocystis neurona sporocysts in opossums (Didelphis virginiana).
Veterinary parasitology    January 5, 2002   Volume 102, Issue 3 179-184 doi: 10.1016/s0304-4017(01)00549-0
Rickard LG, Black SS, Rashmir-Raven A, Hurst G, Dubey JP.Sarcocystis neurona is the most important cause of equine protozoal myeloencephalitis (EPM) in horse in the Americas. The only known definitive host for this parasite in the United States is the opossum (Didelphis virginiana); however, despite the importance of the disease, the epidemiology of the parasite in the definitive host is poorly understood. To begin addressing these data gaps, potential risk factors were evaluated for their association with the presence of sporocysts of S. neurona in opossums live-trapped in March 1999 and November 1999 to May 2000. Sporocysts of S. neurona were foun...
Mice lacking the gene for inducible or endothelial nitric oxide are resistant to sporocyst induced Sarcocystis neurona infections.
Veterinary parasitology    January 5, 2002   Volume 103, Issue 4 315-321 doi: 10.1016/s0304-4017(01)00555-6
Rosypal AC, Lindsay DS, Duncan R, Ahmed SA, Zajac AM, Dubey JP.Equine protozoal myeloencephalitis (EPM) is a neurologic syndrome in horses from the Americas and is usually caused by infection with the apicomplexan parasite, Sarcocystis neurona. Little is known about the role of immunobiological mediators to this parasite. Nitric oxide (NO) is important in resistance to many intracellular parasites. We, therefore, investigated the role of inducible and endothelial NO in resistance to clinical disease caused by S. neurona in mice. Groups of interferon-gamma gene knockout (IFN-gamma-KO) mice, inducible nitric oxide synthase gene knockout (iNOS-KO) mice, endo...
Lymphocyte phenotype subsets in the cerebrospinal fluid of normal horses and horses with equine protozoal myeloencephalitis.
Veterinary therapeutics : research in applied veterinary medicine    October 1, 2001   Volume 2, Issue 4 317-324 
Furr M, Pontzer C, Gasper P.The percentages of T-lymphocytes, lymphocyte subsets CD4+ and CD8+ T-cells, and lymphocyte adhesion molecule CD11a/CD18 were determined in the peripheral blood and cerebrospinal fluid (CSF) of seven normal horses and four horses with equine protozoal myeloencephalitis (EPM) using flow cytometry. There was a greater percentage of CD5+ cells in the CSF (79.0%) than in peripheral blood (67.0%), although this did not achieve statistical significance. Furthermore, the lymphocyte population in CSF comprises a significantly greater (P = .01) percentage of CD8+ T-cells, resulting in a decrease of the ...
Suspected protozoal myeloencephalitis in a two-month-old colt.
The Veterinary record    September 18, 2001   Volume 149, Issue 9 269-273 doi: 10.1136/vr.149.9.269
Gray LC, Magdesian KG, Sturges BK, Madigan JE.A two-month-old Appaloosa colt developed neurological signs shortly after birth involving deficits affecting cranial nerves IV, VII, VIII, IX, X and XII, and possibly nerve VI. The most likely differential diagnoses were congenital anomalies, meningoencephalitides, trauma or nutritional causes. The foal was investigated by the analysis of cerebrospinal fluid (CSF), electromyelography (EMG), brain auditory evoked responses, magnetic resonance imaging (MRI), peripheral nerve biopsy, and Western blot analysis for the presence of intrathecal antibodies to Sarcocystis neurona, the causative agent o...
Safety of ponazuril 15% oral paste in horses.
Veterinary therapeutics : research in applied veterinary medicine    July 1, 2001   Volume 2, Issue 3 223-231 
Kennedy T, Campbell J, Selzer V.Ponazuril, a triazine-derivative compound, is proposed as a treatment for equine protozoal myeloencephalitis caused by Sarcocystis neurona. Ponazuril 15% oral paste was administered to 24 horses at 0, 10, or 30 mg/kg body weight for either 28 or 56 days, representing zero, two, and six times the proposed dosage rate and one and two times the recommended duration of treatment, respectively. Serum chemistry analysis, coagulation profile, and hematology measurements were performed weekly and necropsy evaluations, including histopathology, were conducted for all animals at the end of the study. Mi...
The effects of pyrantel tartrate on Sarcocystis neurona merozoite viability.
Veterinary therapeutics : research in applied veterinary medicine    July 1, 2001   Volume 2, Issue 3 268-276 
Kruttlin EA, Rossano MG, Murphy AJ, Vrable RA, Kaneene JB, Schott HC, Mansfield LS.Sarcocystis neurona is the etiologic agent of equine protozoal myeloencephalitis, a neurologic disease of horses. The present study was designed to test the hypothesis that pyrantel tartrate can kill S. neurona merozoites growing in equine dermal cell culture. Sarcocystis neurona merozoites were exposed to a range of concentrations of pyrantel tartrate or sodium tartrate ranging from 0.001 to 0.01 M. Merozoites were then placed onto equine dermal cell cultures and incubated for 2 weeks to check for viability. At 1 and 2 weeks after inoculation, plaque counts were compared between treatments an...
Efficacy of ponazuril 15% oral paste as a treatment for equine protozoal myeloencephalitis.
Veterinary therapeutics : research in applied veterinary medicine    July 1, 2001   Volume 2, Issue 3 215-222 
Furr M, Kennedy T, MacKay R, Reed S, Andrews F, Bernard B, Bain F, Byars D.Equine protozoal myeloencephalitis (EPM) is a neurologic disease of horses most commonly caused by the protozoan parasite Sarcocystis neurona. Until recently the only treatment option was the combination of a sulfonamide with pyrimethamine. The present study was performed to assess the efficacy of ponazuril, an anticoccidial triazine-based compound, as a treatment for naturally occurring EPM. One hundred one horses with EPM were randomly allocated to treatment with ponazuril 15% oral paste at either 5 or 10 mg/kg body weight for 28 consecutive days. Horses were evaluated clinically and by anal...
Cerebrospinal fluid and serum concentrations of ponazuril in horses.
Veterinary therapeutics : research in applied veterinary medicine    July 1, 2001   Volume 2, Issue 3 232-237 
Furr M, Kennedy T.Ponazuril was administered orally to 10 adult horses at 5 mg/kg body weight, once a day for 28 days. Blood was collected once a week from each horse from Days 0 through 35, daily from Days 35 through 42, and on Day 49. Cerebrospinal fluid (CSF) was also collected once a week from Day 0 through Day 49. Concentrations of ponazuril in the serum and CSF were determined, and pharmacokinetic calculations were performed. Ponazuril was readily absorbed following oral administration; and after 7 days of dosing, the serum concentration was 4.33 +/- 1.10 mg/L, and the mean CSF concentration was 0.162 +/-...
[Equine protozoal myeloencephalitis in the Netherlands? An overview].
Tijdschrift voor diergeneeskunde    June 8, 2001   Volume 126, Issue 10 346-351 
Goehring LS, Sloet van Oldruitenborgh-Oosterbaan MM.Equine protozoal myeloencephalitis (EPM) was diagnosed in a Dutch Warmblood gelding a few months after its export to the United States. The horse came back and was treated here. Additionally, an overview of the disease complex 'EPM' is given. Mode of infection, diagnosis of disease and its differential diagnoses, and general therapeutic options are presented. Although EPM due to infection with Sarcocystis neurona in Europe seems restricted to those horses that return or are imported from North America, the possibility of future cases of EPM caused by an infection with Neospora spp. is briefly ...
The nine-banded armadillo (Dasypus novemcinctus) is an intermediate host for Sarcocystis neurona.
International journal for parasitology    April 18, 2001   Volume 31, Issue 4 330-335 doi: 10.1016/s0020-7519(01)00177-1
Cheadle MA, Tanhauser SM, Dame JB, Sellon DC, Hines M, Ginn PE, MacKay RJ, Greiner EC.The nine-banded armadillo (Dasypus novemcinctus) is an intermediate host of at least three species of Sarcocystis, Sarcocystis dasypi, Sarcocystis diminuta, and an unidentified species; however, life cycles of these species have not been determined. Following feeding of armadillo muscles containing sarcocysts to the Virginia opossum (Didelphis virginiana), the opossums shed sporulated Sarcocystis sporocysts in their faeces. Mean dimensions for sporocysts were 11.0x7.5 microm and each contained four sporozoites and a residual body. Sporocysts were identified as Sarcocystis neurona using PCR and...
Utilization of stress in the development of an equine model for equine protozoal myeloencephalitis.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 211-222 doi: 10.1016/s0304-4017(00)00421-0
Saville WJ, Stich RW, Reed SM, Njoku CJ, Oglesbee MJ, Wunschmann A, Grover DL, Larew-Naugle AL, Stanek JF, Granstrom DE, Dubey JP.Neurologic disease in horses caused by Sarcocystis neurona is difficult to diagnose, treat, or prevent, due to the lack of knowledge about the pathogenesis of the disease. This in turn is confounded by the lack of a reliable equine model of equine protozoal myeloencephalitis (EPM). Epidemiologic studies have implicated stress as a risk factor for this disease, thus, the role of transport stress was evaluated for incorporation into an equine model for EPM. Sporocysts from feral opossums were bioassayed in interferon-gamma gene knockout (KO) mice to determine minimum number of viable S. neurona ...
A review of Sarcocystis neurona and equine protozoal myeloencephalitis (EPM).
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 89-131 doi: 10.1016/s0304-4017(00)00384-8
Dubey JP, Lindsay DS, Saville WJ, Reed SM, Granstrom DE, Speer CA.Equine protozoal myeloencephalitis (EPM) is a serious neurological disease of horses in the Americas. The protozoan most commonly associated with EPM is Sarcocystis neurona. The complete life cycle of S. neurona is unknown, including its natural intermediate host that harbors its sarcocyst. Opossums (Didelphis virginiana, Didelphis albiventris) are its definitive hosts. Horses are considered its aberrant hosts because only schizonts and merozoites (no sarcocysts) are found in horses. EPM-like disease occurs in a variety of mammals including cats, mink, raccoons, skunks, Pacific harbor seals, p...
Interpretation of the detection of Sarcocystis neurona antibodies in the serum of young horses.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 187-195 doi: 10.1016/s0304-4017(00)00390-3
Cook AG, Buechner-Maxwell V, Morrow JK, Ward DL, Parker NA, Dascanio JJ, Ley WB, Cooper W.Horses that are exposed to Sarcocystis neurona, a causative agent of equine protozoal myeloencephalitis, produce antibodies that are detectable in serum by western blot (WB). A positive test is indicative of exposure to the organism. Positive tests in young horses can be complicated by the presence of maternal antibodies. Passive transfer of maternal antibodies to S. neurona from seropositive mares to their foals was evaluated. Foals were sampled at birth (presuckle), at 24h of age (postsuckle), and at monthly intervals. All foals sampled before suckling were seronegative. Thirty-three foals f...
Direct agglutination test for the detection of antibodies to Sarcocystis neurona in experimentally infected animals.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 179-186 doi: 10.1016/s0304-4017(00)00389-7
Lindsay DS, Dubey JP.Equine protozoal myeloencephalitis (EPM) is a serious neurological disease of horses in the Americas. The apicomplexan protozoan most commonly associated with EPM is Sarcocystis neurona. A direct agglutination test (SAT) was developed to detect antibodies to S. neurona in experimentally infected animals. Merozoites of the SN6 strain of S. neurona collected from cell culture were used as antigen and 2-mercaptoethanol was added to the antigen suspension to destroy IgM antibodies when mixed with test sera. Mice fed sporocysts of S. speeri or S. falcatula-like sporocysts from opossums did not sero...
Immunoconversion against Sarcocystis neurona in normal and dexamethasone-treated horses challenged with S. neurona sporocysts.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 197-210 doi: 10.1016/s0304-4017(00)00420-9
Cutler TJ, MacKay RJ, Ginn PE, Gillis K, Tanhauser SM, LeRay EV, Dame JB, Greiner EC.Equine protozoal myeloencephalitis is a common neurologic disease of horses in the Americas usually caused by Sarcocystis neurona. To date, the disease has not been induced in horses using characterized sporocysts from Didelphis virginiana, the definitive host. S. neurona sporocysts from 15 naturally infected opossums were fed to horses seronegative for antibodies against S. neurona. Eight horses were given 5x10(5) sporocysts daily for 7 days. Horses were examined for abnormal clinical signs, and blood and cerebrospinal fluid were harvested at intervals for 90 days after the first day of chall...
Characterization of a Sarcocystis neurona isolate from a Missouri horse with equine protozoal myeloencephalitis.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 143-154 doi: 10.1016/s0304-4017(00)00386-1
Marsh AE, Johnson PJ, Ramos-Vara J, Johnson GC.Little information is available about antigenic variation of Sarcocystis neurona isolated from horses with equine protozoal myeloencephalitis, nor is there much information available on the specific antibody pattern to S. neurona antigens of horses from different geographic regions where S. neurona isolates have been obtained. This communication reports on the characterization of a new S. neurona isolate, SN-MU1. The isolate was obtained from a 3-year old Thoroughbred that had asymmetrical neurological signs and localized skeletal muscle atrophy. This S. neurona isolate is similar to other S. ...
Comparison of Sarcocystis neurona isolates derived from horse neural tissue.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 167-178 doi: 10.1016/s0304-4017(00)00388-5
Mansfield LS, Schott HC, Murphy AJ, Rossano MG, Tanhauser SM, Patterson JS, Nelson K, Ewart SL, Marteniuk JV, Bowman DD, Kaneene JB.Sarcocystis neurona is a protozoan parasite that can cause neurological deficits in infected horses. The route of transmission is by fecal-oral transfer of sporocysts from opossums. However, the species identity and the lifecycle are not completely known. In this study, Sarcocystis merozoites from eight isolates obtained from Michigan horses were compared to S. neurona from a California horse (UCD1), Sarcocystis from a grackle (Cornell), and five Sarcocystis isolates from feral opossums from Michigan. Comparisons were made using several techniques. SDS-PAGE analysis with silver staining showed...
Initiation of a Sarcocystis neurona expressed sequence tag (EST) sequencing project: a preliminary report.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 233-239 doi: 10.1016/s0304-4017(00)00418-0
Howe DK.To accelerate genetic and molecular characterization of Sarcocystis neurona, the primary causative agent of equine protozoal myeloencephalitis (EPM), a sequencing project has been initiated that will generate approximately 7000-8000 expressed sequence tags (ESTs) from this apicomplexan parasite. Poly(A)(+) RNA was isolated from culture-derived S. neurona merozoites, and a cDNA library was constructed in a unidirectional lambda phage cloning vector. Sixty phage clones were randomly picked from the library, and the cDNA inserts were amplified from these clones using the T3 and T7 primers that fl...
Ultrastructure of schizonts and merozoites of Sarcocystis neurona.
Veterinary parasitology    February 27, 2001   Volume 95, Issue 2-4 263-271 doi: 10.1016/s0304-4017(00)00392-7
Speer CA, Dubey JP.The ultrastructure of Sarcocystis neurona schizonts and merozoites was studied in specimens derived from cell culture and from the brains of infected mice. Schizonts and merozoites were located in the host cell cytoplasm without a parasitophorous vacuole at any stage of development. Merozoites divided by endopolygeny. Fully formed merozoites had a pellicle, numerous polysomes and ribosomes, smooth and rough endoplasmic reticulum, 22 subpellicular microtubules, 9-16 dense granules, 25-75 micronemes, a plastid, a Golgi complex, 1-3 mitochondria, a conoid, 2 apical rings, 2 polar rings, 0-6 lipid...