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Equine veterinary journal2022; 55(3); 426-434; doi: 10.1111/evj.13603

Concentrations of neutrophil gelatinase-associated lipocalin are increased in serum and peritoneal fluid from horses with inflammatory abdominal disease and non-strangulating intestinal infarctions.

Abstract: Neutrophil gelatinase-associated lipocalin (NGAL) is produced in response to inflammation in horses, but it has not yet been investigated as a biomarker in horses with the abdominal disease. Objective: To investigate NGAL in serum and peritoneal fluid in horses with the abdominal disease. Methods: Retrospective clinical study. Methods: Data from medical records of 270 horses admitted with acute abdominal disease (simple obstructions [n = 43], strangulating obstructions [n = 104], inflammatory abdominal disease [n = 99], non-strangulating intestinal infarction [NSII, n = 24]) and 9 healthy control horses were reviewed, and serum and peritoneal fluid samples were retrieved from a biobank. NGAL was measured in serum and peritoneal fluid by ELISA. Differences in NGAL concentrations between groups were assessed. Results: Healthy horses had low serum and peritoneal fluid concentrations of NGAL (median = 21.0 and 9.5 μg/L, respectively). Neither serum nor peritoneal fluid NGAL concentrations (median serum, peritoneal fluid) differed between healthy horses and horses with simple (28.1 μg/L, 13.0 μg/L) and strangulating intestinal obstructions (34.7 μg/L, 38.4 μg/L). Horses with NSII (308.0 μg/L, 2163.0 μg/L) and inflammatory abdominal disease (171.1 μg/L, 314.1 μg/L) had higher serum and peritoneal fluid concentrations of NGAL than the other groups (p < 0.001). Peritoneal fluid NGAL concentrations in horses with NSII were higher than in horses with inflammatory abdominal disease (p = 0.03). Conclusions: Retrospective study design; small group of control horses. Conclusions: NGAL is a marker of inflammation in horses with the abdominal disease. The high peritoneal fluid concentration of NGAL in horses with NSII compared to all other groups may render NGAL useful for identifying this condition, which is otherwise difficult to differentiate from other types of peritonitis. Thereby, NGAL may potentially facilitate timely surgical intervention in this group of patients. The results of this study must be evaluated in larger, and preferably prospective, studies to obtain a more comprehensive evaluation of the diagnostic utility of NGAL. Unassigned: Lipocalina associada à gelatinase de neutrófilos (NGAL) é produzida em resposta à inflamação em equinos, mas ainda não foi investigada como biomarcador de equinos com doenças abdominais. Objective: Investigar a NGAL no soro e líquido peritoneal (LP) de equinos com doenças abdominais. Unassigned: Estudo retrospectivo. Methods: Informação de prontuários médicos de 270 equinos com doença abdominal (obstrução simples [n = 43], obstrução estrangulante [n = 104], doença abdominal inflamatória [n = 99], lesão de infarto não estrangulante [NSII, n = 24]) e nove equinos saudáveis como controle foram revisados, e o soro e LP foram obtidos de um biobank. NGAL foi mensurado no soro e LP através de ELISA. Diferenças na concentração de NGAL entre os grupos foi avaliada. Results: Cavalos saudáveis tiveram concentração de NGAL baixas no soro e no LP (mediana = 21.0 e 9.5 μg/L, respectivamente). A concentração de NGAL no soro e no LP não diferiram entre cavalos saudáveis e cavalos com obstrução simples (28.1,13.0) e obstrução estrangulante (34.7, 38.4). Cavalos com NSII (308.0, 2163.0) e doença abdominal inflamatória (171.1314.1) tiveram concentrações mais altas de NGAL no soro e LP quando comparados aos outros grupos (p < 0.001). A concentração de NGAL no LP em cavalos com NSII foi mais alta do que em cavalos com doença abdominal inflamatória (p = 0.03). PRINCIPAIS LIMITAÇÕES: Delineamento de estudo retrospectivo e pequeno grupo de equinos controle. CONCLUSÕES: NGAL é um marcador de inflamação em cavalos com doença abdominal. A concentração alta de NGAL no LP de cavalos com NSII comparado com os outros grupos indica que NGAL pode ser útil em identificar essa condição, o que é usualmente difícil de diferenciar de outros tipos de peritonite. Contudo, NGAL tem o potencial de facilitar a decisão rápida da necessidade de intervenção cirúrgica nesse grupo de pacientes. Os resultados deste estudo devem ser avaliados em uma população maior (e preferencialmente prospectiva) para obter uma melhor avaliação compreensiva da utilidade diagnóstica do NGAL.
Publication Date: 2022-06-19 PubMed ID: 35642326DOI: 10.1111/evj.13603Google Scholar: Lookup
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  • Journal Article

Summary

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The research article investigates the potential of Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in horses with abdominal disease. The results suggest that increased levels of NGAL in serum and peritoneal fluid can signify inflammation, and might be especially useful for the detection of non-strangulating intestinal infarction.

Objectives and Methodology

  • The primary objective of the research was to investigate the role of NGAL, a protein produced in response to inflammation, as a potential biomarker in horses with abdominal disease.
  • The study used a retrospective clinical approach utilizing data from medical records of 270 horses admitted with varying types of acute abdominal disease – simple obstructions, strangulating obstructions, inflammatory abdominal disease, and non-strangulating intestinal infarctions (NSII), along with 9 healthy control horses.
  • They retrieved serum and peritoneal fluid NGAL samples from a biobank and measured NGAL concentrations using ELISA. The concentrations between different groups were then compared for significant differences.

Results

  • Healthy horses confirmed low NGAL levels in both serum and peritoneal fluid.
  • No significant difference in NGAL concentrations was found between healthy horses and those with simple and strangulating obstructions.
  • However, horses with NSII and inflammatory abdominal disease showed significantly raised NGAL concentrations in both serum and peritoneal fluid.
  • Most notably, the peritoneal fluid NGAL concentrations in horses with NSII were higher than in those with inflammatory abdominal disease.

Conclusions

  • The retrospective study concluded that NGAL could serve as an inflammation marker in horses with abdominal disease.
  • Particularly, the high peritoneal fluid NGAL in horses with NSII as compared to all other groups may prove useful in detecting this condition. Typically, peritonitis types are challenging to differentiate, and NGAL may help in deciding for a timely surgical intervention.
  • The researchers caution that the results need further evaluation through larger, preferably prospective, studies for a more comprehensive assessment of NGAL’s diagnostic utility.

Limitations

  • One significant limitation is the study’s retrospective design, which could overlook potential confounding factors affecting the results.
  • Additionally, the small group of control horses may limit the generalizability of the conclusions.

Cite This Article

APA
Winther MF, Haugaard SL, Pihl TH, Jacobsen S. (2022). Concentrations of neutrophil gelatinase-associated lipocalin are increased in serum and peritoneal fluid from horses with inflammatory abdominal disease and non-strangulating intestinal infarctions. Equine Vet J, 55(3), 426-434. https://doi.org/10.1111/evj.13603

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 3
Pages: 426-434

Researcher Affiliations

Winther, Malou F
  • University of Copenhagen, Department of Veterinary Clinical Sciences, Copenhagen, Denmark.
Haugaard, Simon L
  • University of Copenhagen, Department of Veterinary Clinical Sciences, Copenhagen, Denmark.
Pihl, Tina H
  • University of Copenhagen, Department of Veterinary Clinical Sciences, Copenhagen, Denmark.
Jacobsen, Stine
  • University of Copenhagen, Department of Veterinary Clinical Sciences, Copenhagen, Denmark.

MeSH Terms

  • Animals
  • Horses
  • Lipocalin-2
  • Retrospective Studies
  • Colic / veterinary
  • Ascitic Fluid
  • Prospective Studies
  • Horse Diseases / surgery
  • Intestinal Obstruction / veterinary
  • Inflammation / veterinary
  • Biomarkers
  • Infarction / veterinary

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Citations

This article has been cited 4 times.
  1. Laurberg M, Saegerman C, Jacobsen S, Berg LC, Laursen SH, Hoeberg E, Sånge EA, van Galen G. Use of admission serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations as a marker of sepsis and outcome in neonatal foals. PLoS One 2023;18(5):e0285819.
    doi: 10.1371/journal.pone.0285819pubmed: 37200285google scholar: lookup
  2. Jacobsen S, Mortensen CD, Høj EA, Vinther AM, Berg LC, Adler DMT, Verwilghen D, van Galen G. Neutrophil Gelatinase-Associated Lipocalin in Synovial Fluid from Horses with and without Septic Arthritis. Animals (Basel) 2022 Dec 21;13(1).
    doi: 10.3390/ani13010029pubmed: 36611638google scholar: lookup
  3. Galen GV, Olsen E, Siwinska N. Biomarkers of Kidney Disease in Horses: A Review of the Current Literature. Animals (Basel) 2022 Oct 5;12(19).
    doi: 10.3390/ani12192678pubmed: 36230418google scholar: lookup
  4. Eskandari G, Ahmadi Sheikhsarmast S, Ghasemi S, Mohri M. Establishing Reference Values for Serum Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Turkmen Horses: Effects of Gender, Age, Pregnancy and Physical Activity. Vet Med Sci 2026 Jan;12(1):e70755.
    doi: 10.1002/vms3.70755pubmed: 41456952google scholar: lookup