A fresh look at the SarcoFluor antibody test for the detection of specific antibodies to Sarcocystis neurona for the diagnosis of equine protozoal myeloencephalitis.
Abstract: Equine protozoal myeloencephalitis (EPM) is a challenging disease to diagnose in horses with neurological signs. To optimize contemporary diagnostic testing, including the use of serum:CSF antibody ratios, the SarcoFluor antibody test for Sarcocystis neurona requires revalidation. The SarcoFluor, a previously validated immunofluorescent antibody test (IFAT) for the detection of antibodies specific to S. neurona in serum and cerebrospinal fluid (CSF) of naturally infected horses was analyzed using recent data and considering a serum:CSF antibody ratio threshold. Utilization of serum and CSF phosphorylated neurofilament heavy protein (pNfH) concentrations in support of an EPM diagnosis was also evaluated. 172 horses were divided into three groups: EPM-positive horses (EPM+, n=42), neurological non-EPM horses (n=74) confirmed with non-EPM neurological diseases (cervical vertebral compressive myelopathy, equine neuroaxonal dystrophy/equine degenerative myeloencephalopathy), and control horses (control, n=56) without neurological signs and neurological abnormalities on histology. Logistic regression was used to compare EPM diagnostic regimens. Specifically, EPM+ horses were compared with neurological non-EPM horses showing neurological signs. To consider diagnostic utility, post-test probabilities were calculated by titer. When differentiating between EPM and other neurological diseases, the combination of serum and CSF SarcoFluor testing added more information to the model accuracy than either test alone. Using serum and CSF for pNfH in support of an EPM diagnosis did not identify cutoffs with statistically significant odds ratios but increased the overall model accuracy when used with the IFAT. Utilization of IFAT titers against S. neurona in serum and CSF result in a high post-test probability of detecting EPM+ horses in a clinical setting.
Copyright © 2024. Published by Elsevier B.V.
Publication Date: 2024-06-03 PubMed ID: 38897057DOI: 10.1016/j.vetpar.2024.110219Google Scholar: Lookup
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Summary
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The research article focuses on the reassessment of the SarcoFluor antibody test for enhancing the diagnostic accuracy for equine protozoal myeloencephalitis (EPM), a neurological disease in horses. The study also explores the use of serum and cerebrospinal fluid (CSF) phosphorylated neurofilament heavy protein (pNfH) concentrations as supporting evidence for EPM diagnosis.
Research Objective
- The primary research objective is to revalidate the SarcoFluor immunofluorescent antibody test for detecting specific antibodies to Sarcocystis neurona, the causative pathogen of EPM in horses.
- Another key focus of the study is to analyze the application of serum:CSF antibody ratios and the role of pNfH concentrations when used in conjunction for EPM diagnosis.
Methodology
- The study analyzed a total of 172 horses and tested them using different diagnostic approaches. These horses were divided into three groups: EPM-positive horses (EPM+, n=42), horses with other neurological diseases (non-EPM, n=74), and control horses without neurological signs (n=56).
- Alongside the SarcoFluor test, it evaluated the pNfH concentration levels in the serum and CSF of all horses in the study.
- Statistical techniques like logistic regression were used to compare different EPM diagnostic regimens. In particular, the research compared EPM+ horses with neurological non-EPM horses.
Results
- The results showed that the combination of serum:CSF antibody ratios in the SarcoFluor test added more diagnostic information, thereby increasing the model’s accuracy than either of the tests used alone.
- Although no significant odds ratios cut-off level was identified when using pNfH concentration levels, it still contributed to the overall model accuracy when used with the SarcoFluor test.
- The study concluded that utilizing IFAT titers against S. neurona in serum and CSF could result in a high post-test probability of EPM detection in a clinical setting.
Cite This Article
APA
Pandit PS, Smith WA, Finno CJ, Aleman M, Conrad PA, Packham A, Plancarte M, Woolard K, Marsh A, Pusterla N.
(2024).
A fresh look at the SarcoFluor antibody test for the detection of specific antibodies to Sarcocystis neurona for the diagnosis of equine protozoal myeloencephalitis.
Vet Parasitol, 330, 110219.
https://doi.org/10.1016/j.vetpar.2024.110219 Publication
Researcher Affiliations
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA. Electronic address: pspandit@ucdavis.edu.
- One Health Institute, School of Veterinary Medicine, University of California, 1089 Veterinary Medicine Drive, VM3B, Davis, CA 95616, USA.
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Tupper Hall 2108, One Shields Avenue, Davis, CA 95616, USA.
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, 1 Shields Avenue, Davis, CA, 95616, USA.
- One Health Institute, School of Veterinary Medicine, University of California, 1089 Veterinary Medicine Drive, VM3B, Davis, CA 95616, USA.
- One Health Institute, School of Veterinary Medicine, University of California, 1089 Veterinary Medicine Drive, VM3B, Davis, CA 95616, USA.
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, 1 Shields Avenue, Davis, CA, 95616, USA.
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, 1920 Coffey Road, Columbus, OH, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Tupper Hall 2108, One Shields Avenue, Davis, CA 95616, USA.
Conflict of Interest Statement
Declaration of Competing Interest P.S.P, W.A.S., C.J.F., M.A., P.A.C., A.P., M.P., K.W., and N.P. work for the School of Veterinary Medicine, University of California-Davis, which markets the SarcoFluor test for diagnostic purposes.
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