Comparison of Flowmetric Plethysmography and Forced Oscillatory Mechanics to Measure Airway Hyperresponsiveness in Horses.
Abstract: Airway hyperresponsiveness (AHR) is linked to airway inflammation and is considered a key manifestation of mild/moderate equine asthma (EA). The study purpose was to determine whether two modalities of non-invasive lung function testing (FOM-forced oscillatory mechanics vs. FP-flowmetric plethysmography) establish the same clinical diagnosis of AHR in horses, using histamine bronchoprovocation. Nineteen horses (3-25 years, 335-650 kg) with clinical signs suggestive of mild/moderate equine asthma were enrolled. FOM and FP testing was performed in each horse on two consecutive days, using a randomized cross-over design. AHR was defined by the histamine dose needed to double FOM baseline resistance, or to achieve a 35% increase in FP delta flow. Bronchoalveolar lavage fluid (BALF) was subsequently collected and stained with modified Wright's and toluidine blue stains. Binary statistical tests (related samples -test, Mann-Whitney , Chi-square analyses) were performed to compare study groups, with < 0.05 considered significant. Abnormal BALF cytology confirmed EA in 14/19 (73.7%) horses. Both FOM and FP revealed AHR in 7/14 (50%) of these EA horses. An additional 4/19 (21.1%) horses showed AHR based on FP but not FOM, including two horses with normal BALF cytology. A diagnosis of AHR was more often associated with FP than FOM ( = 0.013), although the prevalence of AHR was significantly higher in EA vs. non-EA horses, regardless of testing methodology. The phase angle between thoracic and abdominal components of breathing did not differ between test groups. In conclusion, FP diagnosed AHR more frequently than did FOM, including horses with no other diagnostic evidence of EA. Without further evaluation, these two testing modalities of AHR cannot be used interchangeably.
Copyright © 2021 Dixon, Bedenice and Mazan.
Publication Date: 2021-02-22 PubMed ID: 33693040PubMed Central: PMC7937713DOI: 10.3389/fvets.2020.511023Google Scholar: Lookup
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Summary
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The researchers are trying to compare two non-invasive lung function tests (Forced Oscillatory Mechanics (FOM) and Flowmetric Plethysmography (FP)) in diagnosing Airway hyperresponsiveness (AHR), a common symptom of mild/moderate equine asthma in horses.
Research Background and Aim
- Airway Hyperresponsiveness (AHR) is a common symptom of mild/moderate equine asthma (EA), a condition that causes inflammation in the airways of horses.
- The main purpose of this research is to compare the effectiveness of two non-invasive lung function tests, Forced Oscillatory Mechanics (FOM) and Flowmetric Plethysmography (FP), in diagnosing AHR in horses.
Methodology
- Nineteen horses showing clinical signs of mild/moderate EA were enrolled for this study.
- The horses were subjected to FOM and FP tests on two consecutive days, following a randomized cross-over design to verify the diagnosis of AHR.
- The authors defined AHR either by the requirement of the dose of histamine needed to double the baseline resistance of FOM, or to achieve a 35% increase in the delta flow measured by the FP test.
- Bronchoalveolar lavage fluid (BALF) samples were collected and stained with modified Wright’s and toluidine blue stains for analysis.
Findings
- The examination of BALF cytology confirmed the prevalence of EA in about 73.7% (14 out of 19) of the horses.
- 50% of these EA horses were diagnosed with AHR using both FOM and FP tests.
- An additional 21.1% of the horses showed AHR based on the FP test but not FOM, including two horses with normal BALF cytology.
- The FP test was found to diagnose AHR more often than FOM (A significant difference found with a p-value < 0.05).
Conclusions
- The study concludes that the FP test diagnosed AHR more frequently than the FOM test, including in horses with no other diagnostic evidence of EA.
- Thus, these two testing modalities for AHR cannot be used interchangeably without further evaluation.
Cite This Article
APA
Dixon CE, Bedenice D, Mazan MR.
(2021).
Comparison of Flowmetric Plethysmography and Forced Oscillatory Mechanics to Measure Airway Hyperresponsiveness in Horses.
Front Vet Sci, 7, 511023.
https://doi.org/10.3389/fvets.2020.511023 Publication
Researcher Affiliations
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States.
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States.
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
This article includes 55 references
- Couëtil LL, Cardwell JM, Gerber V, Lavoie JP, Léguillette R, Richard EA. Inflammatory Airway Disease of Horses--Revised Consensus Statement.. J Vet Intern Med 2016 Mar-Apr;30(2):503-15.
- Audrit KJ, Delventhal L, Aydin Ö, Nassenstein C. The nervous system of airways and its remodeling in inflammatory lung diseases.. Cell Tissue Res 2017 Mar;367(3):571-590.
- Nensa F, Kotschy-Lang N, Smith HJ, Marek W, Merget R. Assessment of airway hyperresponsiveness: comparison of spirometry and body plethysmography.. Adv Exp Med Biol 2013;755:1-9.
- Nolen-Walston RD, Kuehn H, Boston RC, Mazan MR, Wilkins PA, Bruns S, Hoffman AM. Reproducibility of airway responsiveness in horses using flowmetric plethysmography and histamine bronchoprovocation.. J Vet Intern Med 2009 May-Jun;23(3):631-5.
- Mazan MR, Hoffman AM, Manjerovic N. Comparison of forced oscillation with the conventional method for histamine bronchoprovocation testing in horses.. Am J Vet Res 1999 Feb;60(2):174-80.
- Hoffman A, Kuehn H, Riedelberger K, Kupcinskas R, Miskovic MB. Flowmetric comparison of respiratory inductance plethysmography and pneumotachography in horses.. J Appl Physiol (1985) 2001 Dec;91(6):2767-75.
- Klein HJ, Deegen E. Histamine inhalation provocation test: method to identify nonspecific airway reactivity in equids.. Am J Vet Res 1986 Aug;47(8):1796-800.
- Derksen FJ, Scott D, Robinson NE, Slocombe RF, Armstrong PJ. Intravenous histamine administration in ponies with recurrent airway obstruction (heaves).. Am J Vet Res 1985 Apr;46(4):774-7.
- Wichtel M, Gomez D, Burton S, Wichtel J, Hoffman A. Relationships between equine airway reactivity measured by flowmetric plethysmography and specific indicators of airway inflammation in horses with suspected inflammatory airway disease.. Equine Vet J 2016 Jul;48(4):466-71.
- Pacheco AP, Paradis MR, Hoffman AM, Hermida P, Sanchez A, Nadeau JA, Tufts M, Mazan MR. Age effects on blood gas, spirometry, airway reactivity, and bronchoalveolar lavage fluid cytology in clinically healthy horses.. J Vet Intern Med 2014 Mar-Apr;28(2):603-8.
- Hoffman A, Mazan MR. How to test for airway hyper-reactivity: toward a better diagnosis of inflammatory airway disease. Annual Convention of the AAEP Seattle, WA: IVIS; (2005).
- Houtsma A, Bedenice D, Pusterla N, Pugliese B, Mapes S, Hoffman AM, Paxson J, Rozanski E, Mukherjee J, Wigley M, Mazan MR. Association between inflammatory airway disease of horses and exposure to respiratory viruses: a case control study.. Multidiscip Respir Med 2015;10:33.
- Young SS, Tesarowski D. Respiratory mechanics of horses measured by conventional and forced oscillation techniques.. J Appl Physiol (1985) 1994 Jun;76(6):2467-72.
- Hoffman AM, Mazan MR, Ellenberg S. Association between bronchoalveolar lavage cytologic features and airway reactivity in horses with a history of exercise intolerance.. Am J Vet Res 1998 Feb;59(2):176-81.
- Hoffman AM, Oura TJ, Riedelberger KJ, Mazan MR. Plethysmographic comparison of breathing pattern in heaves (recurrent airway obstruction) versus experimental bronchoconstriction or hyperpnea in horses.. J Vet Intern Med 2007 Jan-Feb;21(1):184-92.
- Miller C, Hoffman AM, Hunter J. Thoracoabdominal asynchrony failed to grade airway obstructions in foals.. J Appl Physiol (1985) 2000 Jun;88(6):2081-7.
- Mazan M. Respiratory secretions. Interpretation of Equine Laboratory Diagnostics Hoboken, NJ: John Wiley & Sons; (2017). p. 363.
- Hoffman AM. Clinical Application of Pulmonary Function Testing in Horses. Ithaca, NY: IVIS; (2002).
- Couëtil LL, Hoffman AM, Hodgson J, Buechner-Maxwell V, Viel L, Wood JL, Lavoie JP. Inflammatory airway disease of horses.. J Vet Intern Med 2007 Mar-Apr;21(2):356-61.
- Depecker M, Richard EA, Pitel PH, Fortier G, Leleu C, Couroucé-Malblanc A. Bronchoalveolar lavage fluid in Standardbred racehorses: influence of unilateral/bilateral profiles and cut-off values on lower airway disease diagnosis.. Vet J 2014 Jan;199(1):150-6.
- Léguillette R, Tohver T, Bond SL, Nicol JA, McDonald KJ. Effect of Dexamethasone and Fluticasone on Airway Hyperresponsiveness in Horses With Inflammatory Airway Disease.. J Vet Intern Med 2017 Jul;31(4):1193-1201.
- Lavoie JP, Léguillette R, Pasloske K, Charette L, Sawyer N, Guay D, Murphy T, Hickey GJ. Comparison of effects of dexamethasone and the leukotriene D4 receptor antagonist L-708,738 on lung function and airway cytologic findings in horses with recurrent airway obstruction.. Am J Vet Res 2002 Apr;63(4):579-85.
- Gerber V, Schott Ii HC, Robinson NE. Owner assessment in judging the efficacy of airway disease treatment.. Equine Vet J 2011 Mar;43(2):153-8.
- Couëtil LL, Art T, de Moffarts B, Becker M, Mélotte D, Jaspar F, Bureau F, Lekeux P. Effect of beclomethasone dipropionate and dexamethasone isonicotinate on lung function, bronchoalveolar lavage fluid cytology, and transcription factor expression in airways of horses with recurrent airway obstruction.. J Vet Intern Med 2006 Mar-Apr;20(2):399-406.
- Bedenice D, Mazan MR, Hoffman AM. Association between cough and cytology of bronchoalveolar lavage fluid and pulmonary function in horses diagnosed with inflammatory airway disease.. J Vet Intern Med 2008 Jul-Aug;22(4):1022-8.
- Mazan MR, Vin R, Hoffman AM. Radiographic scoring lacks predictive value in inflammatory airway disease.. Equine Vet J 2005 Nov;37(6):541-5.
- Hare JE, Viel L. Pulmonary eosinophilia associated with increased airway responsiveness in young racing horses.. J Vet Intern Med 1998 May-Jun;12(3):163-70.
- Richard EA, Fortier GD, Denoix JM, Art T, Lekeux PM, Van Erck E. Influence of subclinical inflammatory airway disease on equine respiratory function evaluated by impulse oscillometry.. Equine Vet J 2009 Apr;41(4):384-9.
- Cullimore AM, Secombe CJ, Lester GD, Robertson ID. Bronchoalveolar lavage fluid cytology and airway hyper-reactivity in clinically normal horses.. Aust Vet J 2018 Aug;96(8):291-296.
- Brusasco V, Crimi E, Pellegrino R. Airway hyperresponsiveness in asthma: not just a matter of airway inflammation.. Thorax 1998 Nov;53(11):992-8.
- Baroffio M, Barisione G, Crimi E, Brusasco V. Noninflammatory mechanisms of airway hyper-responsiveness in bronchial asthma: an overview.. Ther Adv Respir Dis 2009 Aug;3(4):163-74.
- Djukanović R, Lai CK, Wilson JW, Britten KM, Wilson SJ, Roche WR, Howarth PH, Holgate ST. Bronchial mucosal manifestations of atopy: a comparison of markers of inflammation between atopic asthmatics, atopic nonasthmatics and healthy controls.. Eur Respir J 1992 May;5(5):538-44.
- Schmekel B, Smith HJ. The diagnostic capacity of forced oscillation and forced expiration techniques in identifying asthma by isocapnic hyperpnoea of cold air.. Eur Respir J 1997 Oct;10(10):2243-9.
- Khalid I, Morris ZQ, Khalid TJ, Nisar A, Digiovine B. Using spirometry to rule out restriction in patients with concomitant low forced vital capacity and obstructive pattern.. Open Respir Med J 2011;5:44-50.
- Chinet T, Pelle G, Macquin-Mavier I, Lorino H, Harf A. Comparison of the dose-response curves obtained by forced oscillation and plethysmography during carbachol inhalation.. Eur Respir J 1988 Jul;1(7):600-5.
- Naji N, Keung E, Kane J, Watson RM, Killian KJ, Gauvreau GM. Comparison of changes in lung function measured by plethymography and IOS after bronchoprovocation.. Respir Med 2013 Apr;107(4):503-10.
- Peters U, Suratt BT, Bates JHT, Dixon AE. Beyond BMI: Obesity and Lung Disease.. Chest 2018 Mar;153(3):702-709.
- Jones RL, Nzekwu MM. The effects of body mass index on lung volumes.. Chest 2006 Sep;130(3):827-33.
- Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, Atlan G. Effects of obesity on respiratory resistance.. Chest 1993 May;103(5):1470-6.
- Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function.. J Appl Physiol (1985) 2010 Jan;108(1):206-11.
- Chapman DG, Berend N, King GG, Salome CM. Increased airway closure is a determinant of airway hyperresponsiveness.. Eur Respir J 2008 Dec;32(6):1563-9.
- Parraguez Arévalo A, Rojas Navarro F, Ruz Céspedes M, Medina González P, Escobar Cabello M, Muñoz Cofré R. The impact of obesity on specific airway resistance and conductance among schoolchildren.. Arch Argent Pediatr 2018 Apr 1;116(2):e227-e233.
- Kalhoff H, Breidenbach R, Smith HJ, Marek W. Impulse oscillometry in preschool children and association with body mass index.. Respirology 2011 Jan;16(1):174-9.
- Lauhkonen E, Koponen P, Nuolivirta K, Paassilta M, Toikka J, Saari A, Korppi M. Obesity and bronchial obstruction in impulse oscillometry at age 5-7 years in a prospective post-bronchiolitis cohort.. Pediatr Pulmonol 2015 Sep;50(9):908-14.
- Assumpção MS, Ribeiro JD, Wamosy RMG, Figueiredo FCXS, Parazzi PLF, Schivinski CIS. Impulse oscillometry and obesity in children.. J Pediatr (Rio J) 2018 Jul-Aug;94(4):419-424.
- Criée CP, Sorichter S, Smith HJ, Kardos P, Merget R, Heise D, Berdel D, Köhler D, Magnussen H, Marek W, Mitfessel H, Rasche K, Rolke M, Worth H, Jörres RA. Body plethysmography--its principles and clinical use.. Respir Med 2011 Jul;105(7):959-71.
- Hollier CA, Harmer AR, Maxwell LJ, Menadue C, Willson GN, Black DA, Piper AJ. Validation of respiratory inductive plethysmography (LifeShirt) in obesity hypoventilation syndrome.. Respir Physiol Neurobiol 2014 Apr 1;194:15-22.
- Rétory Y, David P, de Picciotto C, Niedzialkowski P, Bonay M, Petitjean M. Validity of thoracic respiratory inductive plethysmography in high body mass index subjects.. Respir Physiol Neurobiol 2017 Aug;242:52-58.
- Lo D, Kennedy JL, Kurten RC, Panettieri RA Jr, Koziol-White CJ. Modulation of airway hyperresponsiveness by rhinovirus exposure.. Respir Res 2018 Oct 29;19(1):208.
- Lavoie JP, Pascoe JR, Kurpershoek CJ. Effects of xylazine on ventilation in horses.. Am J Vet Res 1992 Jun;53(6):916-20.
- Chen YC, Hsiao TC. Instantaneous phase difference analysis between thoracic and abdominal movement signals based on complementary ensemble empirical mode decomposition.. Biomed Eng Online 2016 Oct 6;15(1):112.
- Broadstone RV, Gray PR, Robinson NE, Derksen FJ. Effects of xylazine on airway function in ponies with recurrent airway obstruction.. Am J Vet Res 1992 Oct;53(10):1813-7.
- Lavoie JP, Pascoe JR, Kurpershoek CJ. Effect of head and neck position on respiratory mechanics in horses sedated with xylazine.. Am J Vet Res 1992 Sep;53(9):1652-7.
- Mazan MR, Hoffman AM, Kuehn H, Deveney EF. Effect of aerosolized albuterol sulfate on resting energy expenditure determined by use of open-flow indirect calorimetry in horses with recurrent airway obstruction.. Am J Vet Res 2003 Feb;64(2):235-42.
- Nolen-Walston R, Mazan MR, Bedenice D, Hoffman AM. The effect of Detomidine sedation on respiratory system resistance and histamine bronchoprovocation measured by forced oscillatory mechanics. ACVIM Forum Baltimore, MD (2005).
Citations
This article has been cited 6 times.- Frippiat T, Art T, Tosi I. Airway Hyperresponsiveness, but Not Bronchoalveolar Inflammatory Cytokines Profiles, Is Modified at the Subclinical Onset of Severe Equine Asthma. Animals (Basel) 2023 Aug 1;13(15).
- Mahalingam-Dhingra A, Mazan MR, Bedenice D, Ceresia M, Minuto J, Deveney EF. A CONSORT-guided, randomized, double-blind, controlled pilot clinical trial of inhaled lidocaine for the treatment of equine asthma. Can J Vet Res 2022 Apr;86(2):116-124.
- Mönki J, Saastamoinen M, Karikoski N, Norring M, Rajamäki M, Mykkänen A. Effects of Bedding Material on Equine Lower Airway Inflammation: A Comparison of Two Peat Beddings, Wood Pellet, and Straw Pellet. Front Vet Sci 2021;8:799645.
- Simões J, Tilley P. Decision Making in Severe Equine Asthma-Diagnosis and Monitoring. Animals (Basel) 2023 Dec 16;13(24).
- Mönki J, Holopainen M, Ruhanen H, Karikoski N, Käkelä R, Mykkänen A. Lipid species profiling of bronchoalveolar lavage fluid cells of horses housed on two different bedding materials. Sci Rep 2023 Dec 8;13(1):21778.
- Byrne DP, Keeshan B, Hosgood G, Adler A, Mosing M. Comparison of electrical impedance tomography and spirometry-based measures of airflow in healthy adult horses. Front Physiol 2023;14:1164646.
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