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Comparison of Tracheal Wash and Bronchoalveolar Lavage Cytology in 154 Horses With and Without Respiratory Signs in a Referral Hospital Over 2009-2015.
Abstract: Most equine lower respiratory diseases present as increased airway neutrophilia, which can be detected in tracheal wash (TW) or bronchoalveolar lavage fluid (BALF) cytology samples. The aim was to compare the TW and BALF results in a population of client-owned horses with and without clinical respiratory disease signs. A secondary aim was to determine the sensitivity (Se) and specificity (Sp) of TW and BALF neutrophilia in detecting respiratory disease. The cutoff values for neutrophils were also evaluated. Retrospective data from 154 horses of various breeds that had been subject to both TW and bronchoalveolar lavage (BAL) sampling at rest during 2009-2015 were used. The horses were divided into three groups based on the presenting signs, physical examination, and endoscopy mucus score. Neutrophil counts of >20% in TW and >5% in BAL were considered abnormal. Cytology results between groups, correlations between TW and BALF cell types, and tracheal mucus score were analyzed. Two graph receiving operating characteristic (ROC) curves of the neutrophil percentage values of TW and BALF were created to determine the optimal cutoff values and to calculate the diagnostic Se and Sp for diagnosing airway inflammation in horses with and without clinical respiratory signs. The Se and Sp of TW and BALF neutrophil percentages were further estimated using a two-test one-population Bayesian latent class model. The two tests showed substantial agreement, and only 17.5% of the horses were classified differently (healthy vs. diseased). The neutrophil percentage was found to correlate between TW and BALF. The Se and Sp of TW were generally higher than for BAL when estimated with area under the curve or Bayesian model. Cutoff values of 17.7% for TW and 7% for BALF were indicated by the ROCs. We conclude that TW is a more sensitive and specific method in our patient population. We suggest that the current neutrophil cutoff values of 20% for TW and 5% for BALF would still be appropriate to use in clinical diagnosis of airway inflammation. However, further studies with other cell types and in other populations are warranted to determine the best sampling method for individual horses.
Publication Date: 2018-03-26 PubMed ID: 29632867PubMed Central: PMC5879091DOI: 10.3389/fvets.2018.00061Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Bayesian Analysis
- Bronchoalveolar Lavage
- Clinical Examination
- Clinical Pathology
- Clinical Signs
- Correlation Analysis
- Cytology
- Diagnostic Technique
- Disease Diagnosis
- Disease Treatment
- Equine Health
- Horses
- Neutrophils
- Respiratory Disease
- Retrospective Study
- Trachea
- Veterinary Practice
- Veterinary Research
- White Blood Cells
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study focuses on comparing the effectiveness of tracheal wash (TW) and bronchoalveolar lavage fluid (BALF) cytology in detecting respiratory diseases in horses. It revealed that TW is generally more specific and sensitive.
Objectives of the Study
- The main aim of the research was to compare TW and BALF cytology data in a group of horses showing respiratory disease symptoms to those without.
- The secondary aim was to ascertain the specificity and sensitivity of TW and BALF neutrophilia in identifying respiratory diseases in horses. The study also aimed at determining the cutoff values for neutrophils.
Methodology
- Retrospective data from 154 horses of different breeds, sampled between 2009 and 2015 while at rest, were used.
- The horses were classified into three groups based on the observed signs, physical examination results, and endoscopy mucus score, with neutrophil counts over 20% in TW and above 5% in BAL considered as abnormal.
- The researchers analyzed the cytology results between these groupings, studied the correlation between various cell types in TW and BALF and tracheal mucus score.
- To establish optimal cutoff values, and to compute the diagnostic specificity and sensitivity of diagnosing airway inflammation in horses exhibiting respiratory signs, two graph receiving operating characteristic (ROC) curves of the neutrophil percentage values of TW and BALF were created.
- The specificity and sensitivity of TW and BALF neutrophil percentages were further estimated using a two-test one-population Bayesian latent class model.
Findings of the Study
- The two methods showed substantial agreement, with only 17.5% of the horses classified differently (healthy vs. diseased).
- A connection was deduced between the percentage of neutrophils in TW and BALF.
- Generally, TW had a higher sensitivity and specificity than BALF, as estimated with the curve area or Bayesian model.
- ROCs proposed cutoff values of 17.7% for TW and 7% for BALF.
Conclusions
- Based on the findings, the researchers concluded that TW is a more sensitive and specific technique in diagnosing respiratory diseases in their study population.
- The currently employed neutrophil cutoff values of 20% for TW and 5% for BALF were still seen as appropriate for airway inflammation clinical diagnosis.
- The researchers suggest the need for additional research involving different populations and cell types to determine the most effective method of sampling for individual horses.
Cite This Article
APA
Rossi H, Virtala AM, Raekallio M, Rahkonen E, Rajamu00e4ki MM, Mykku00e4nen A.
(2018).
Comparison of Tracheal Wash and Bronchoalveolar Lavage Cytology in 154 Horses With and Without Respiratory Signs in a Referral Hospital Over 2009-2015.
Front Vet Sci, 5, 61.
https://doi.org/10.3389/fvets.2018.00061 Publication
Researcher Affiliations
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
References
This article includes 33 references
- Mair TS, Stokes CR, Bourne FJ. Cellular content of secretions obtained by lavage from different levels of the equine respiratory tract.. Equine Vet J 1987 Sep;19(5):458-62.
- Hoffman AM. Bronchoalveolar lavage: sampling technique and guidelines for cytologic preparation and interpretation.. Vet Clin North Am Equine Pract 2008 Aug;24(2):423-35, vii-viii.
- Couu00ebtil L, Hawkins J. Diagnostic tests and therapeutic procedures. In: Couu00ebtil L, Hawkins J, editors. Respiratory Diseases of the Horse. London: Manson Publishing Ltd; (2013). p. 55u20138.
- Couu00ebtil LL, Cardwell JM, Gerber V, Lavoie JP, Lu00e9guillette R, Richard EA. Inflammatory Airway Disease of Horses--Revised Consensus Statement.. J Vet Intern Med 2016 Mar-Apr;30(2):503-15.
- Malikides N, Hughes KJ, Hodgson DR, Hodgson JL. Comparison of tracheal aspirates and bronchoalveolar lavage in racehorses. 2. Evaluation of the diagnostic significance of neutrophil percentage.. Aust Vet J 2003 Nov;81(11):685-7.
- Leclere M, Lavoie-Lamoureux A, Lavoie JP. Heaves, an asthma-like disease of horses.. Respirology 2011 Oct;16(7):1027-46.
- Bullone M, Lavoie JP. Asthma "of horses and men"--how can equine heaves help us better understand human asthma immunopathology and its functional consequences?. Mol Immunol 2015 Jul;66(1):97-105.
- Richard EA, Fortier GD, Lekeux PM, Van Erck E. Laboratory findings in respiratory fluids of the poorly-performing horse.. Vet J 2010 Aug;185(2):115-22.
- Koblinger K, Nicol J, McDonald K, Wasko A, Logie N, Weiss M, Lu00e9guillette R. Endoscopic assessment of airway inflammation in horses.. J Vet Intern Med 2011 Sep-Oct;25(5):1118-26.
- Wasko AJ, Barkema HW, Nicol J, Fernandez N, Logie N, Lu00e9guillette R. Evaluation of a risk-screening questionnaire to detect equine lung inflammation: results of a large field study.. Equine Vet J 2011 Mar;43(2):145-52.
- Depecker M, Richard EA, Pitel PH, Fortier G, Leleu C, Couroucu00e9-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.
- Derksen FJ, Brown CM, Sonea I, Darien BJ, Robinson NE. Comparison of transtracheal aspirate and bronchoalveolar lavage cytology in 50 horses with chronic lung disease.. Equine Vet J 1989 Jan;21(1):23-6.
- Hughes KJ, Malikides N, Hodgson DR, Hodgson JL. Comparison of tracheal aspirates and bronchoalveolar lavage in racehorses. 1. Evaluation of cytological stains and the percentage of mast cells and eosinophils.. Aust Vet J 2003 Nov;81(11):681-4.
- Fraipont A, Van Erck E, Ramery E, Richard E, Denoix JM, Lekeux P, Art T. Subclinical diseases underlying poor performance in endurance horses: diagnostic methods and predictive tests.. Vet Rec 2011 Aug 6;169(6):154.
- Winder NC, Gru00fcnig G, Hermann M, von Fellenberg R. Comparison of bronchoalveolar lavage and respiratory secretion cytology in horses with histologically diagnosed pulmonary disease.. Schweiz Arch Tierheilkd 1991;133(3):123-30.
- Winder NC, Hermann M, Gru00fcnig G, Hulliger C, Von Fellenberg R. Comparison of bronchoalveolar lavage and respiratory secretion cytology in horses with clinically diagnosed chronic pulmonary disease.. Schweiz Arch Tierheilkd 1990;132(9):505-10.
- Dunn OJ. Multiple comparisons using rank sums. Technometrics (1964) 6:241u201352.10.1080/00401706.1964.10490181
- Landis JR, Koch GG. The measurement of observer agreement for categorical data.. Biometrics 1977 Mar;33(1):159-74.
- Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests.. Prev Vet Med 2000 May 30;45(1-2):23-41.
- Kostoulas P, Nielsen SS, Branscum AJ, Johnson WO, Dendukuri N, Dhand NK, Toft N, Gardner IA. STARD-BLCM: Standards for the Reporting of Diagnostic accuracy studies that use Bayesian Latent Class Models.. Prev Vet Med 2017 Mar 1;138:37-47.
- Branscum AJ, Gardner IA, Johnson WO. Estimation of diagnostic-test sensitivity and specificity through Bayesian modeling.. Prev Vet Med 2005 May 10;68(2-4):145-63.
- Altman DG. Practical Statistics for Medical Research. London: Chapman and Hall/CRC; (1991). 624 p.
- McHugh ML. Interrater reliability: the kappa statistic.. Biochem Med (Zagreb) 2012;22(3):276-82.
- Allen KJ, Tremaine WH, Franklin SH. Prevalence of inflammatory airway disease in national hunt horses referred for investigation of poor athletic performance.. Equine Vet J Suppl 2006 Aug;(36):529-34.
- Malikides N, Hughes KJ, Hodgson JL. Comparison of tracheal aspirates before and after high-speed treadmill exercise in racehorses.. Aust Vet J 2007 Oct;85(10):414-9.
- Sweeney CR, Humber KA, Roby KA. Cytologic findings of tracheobronchial aspirates from 66 thoroughbred racehorses.. Am J Vet Res 1992 Jul;53(7):1172-5.
- Christley RM, Hodgson DR, Rose RJ, Hodgson JL, Wood JL, Reid SW. Coughing in thoroughbred racehorses: risk factors and tracheal endoscopic and cytological findings.. Vet Rec 2001 Jan 27;148(4):99-104.
- Robinson NE, Karmaus W, Holcombe SJ, Carr EA, Derksen FJ. Airway inflammation in Michigan pleasure horses: prevalence and risk factors.. Equine Vet J 2006 Jul;38(4):293-9.
- Robinson NE. International Workshop on Equine Chronic Airway Disease. Michigan State University 16-18 June 2000.. Equine Vet J 2001 Jan;33(1):5-19.
- McGorum BC, Dixon PM. The analysis and interpretation of equine bronchoalveolar lavage fluid (BALF) cytology. Equine Vet Educ (1994) 6:203u20139.10.1111/j.2042-3292.1994.tb01136.x
- Gerber V, Robinson NE, Luethi S, Marti E, Wampfler B, Straub R. Airway inflammation and mucus in two age groups of asymptomatic well-performing sport horses.. Equine Vet J 2003 Jul;35(5):491-5.
- Fernandez NJ, Hecker KG, Gilroy CV, Warren AL, Lu00e9guillette R. Reliability of 400-cell and 5-field leukocyte differential counts for equine bronchoalveolar lavage fluid.. Vet Clin Pathol 2013 Mar;42(1):92-8.
- Gerber V, Straub R, Marti E, Hauptman J, Herholz C, King M, Imhof A, Tahon L, Robinson NE. Endoscopic scoring of mucus quantity and quality: observer and horse variance and relationship to inflammation, mucus viscoelasticity and volume.. Equine Vet J 2004 Nov;36(7):576-82.
Citations
This article has been cited 15 times.- Lemonnier LC, Couroucu00e9 A, Cessans M, Petit L, Cardwell JM, Barbazanges P, Toquet M-, Richard EA. Detection of fungi in the airways of horses according to the sample site: a methodological study.. Vet Res Commun 2023 Sep 13;.
- Shawaf T, Schuberth HJ, Hussen J. Immune cell composition of the bronchoalveolar lavage fluid in healthy and respiratory diseased dromedary camels.. BMC Vet Res 2022 Sep 21;18(1):353.
- Klier J, Fuchs S, Winter G, Gehlen H. Inhalative Nanoparticulate CpG Immunotherapy in Severe Equine Asthma: An Innovative Therapeutic Concept and Potential Animal Model for Human Asthma Treatment.. Animals (Basel) 2022 Aug 16;12(16).
- Simu00f5es J, Batista M, Tilley P. The Immune Mechanisms of Severe Equine Asthma-Current Understanding and What Is Missing.. Animals (Basel) 2022 Mar 16;12(6).
- Chai J, Capik SF, Kegley B, Richeson JT, Powell JG, Zhao J. Bovine respiratory microbiota of feedlot cattle and its association with disease.. Vet Res 2022 Jan 12;53(1):4.
- Karagianni AE, Kurian D, Cillu00e1n-Garcia E, Eaton SL, Wishart TM, Pirie RS. Training associated alterations in equine respiratory immunity using a multiomics comparative approach.. Sci Rep 2022 Jan 10;12(1):427.
- Mu00f6nki J, Saastamoinen M, Karikoski N, Norring M, Rajamu00e4ki M, Mykku00e4nen 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.
- Lo Feudo CM, Stucchi L, Alberti E, Stancari G, Conturba B, Zucca E, Ferrucci F. The Role of Thoracic Ultrasonography and Airway Endoscopy in the Diagnosis of Equine Asthma and Exercise-Induced Pulmonary Hemorrhage.. Vet Sci 2021 Nov 15;8(11).
- Karagianni AE, Eaton SL, Kurian D, Cillu00e1n-Garcia E, Twynam-Perkins J, Raper A, Wishart TM, Pirie RS. Application across species of a one health approach to liquid sample handling for respiratory based -omics analysis.. Sci Rep 2021 Jul 12;11(1):14292.
- Shawaf T, Almubarak A, Alhumam N, Almathen F, Hussen J. Cytological analysis of tracheal wash and bronchoalveolar lavage fluid in health and respiratory disease in dromedary camels.. PeerJ 2021;9:e11723.
- Vitale V, Bonelli F, Briganti A, Sgorbini M. Bronchoalveolar lavage fluid cytological findings in healthy Amiata donkeys.. Open Vet J 2021 Jan-Mar;11(1):160-164.
- Davis KU, Sheats MK. Differential gene expression and Ingenuity Pathway Analysis of bronchoalveolar lavage cells from horses with mild/moderate neutrophilic or mastocytic inflammation on BAL cytology.. Vet Immunol Immunopathol 2021 Apr;234:110195.
- Couetil L, Cardwell JM, Leguillette R, Mazan M, Richard E, Bienzle D, Bullone M, Gerber V, Ivester K, Lavoie JP, Martin J, Moran G, Niedu017awiedu017a A, Pusterla N, Swiderski C. Equine Asthma: Current Understanding and Future Directions.. Front Vet Sci 2020;7:450.
- Brankston G, Greer AL, Marshall Q, Lang B, Moore K, Hodgins D, Hennessey JTG, Beeler-Marfisi J. Increased Weekly Mean PM(2.5), and NO(2) Are Associated With Increased Proportions of Lower Airway Granulocytes in Ontario Horses.. Front Vet Sci 2020;7:185.
- Sheats MK, Davis KU, Poole JA. Comparative Review of Asthma in Farmers and Horses.. Curr Allergy Asthma Rep 2019 Oct 10;19(11):50.
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