Distribution of venous remodeling in exercise-induced pulmonary hemorrhage of horses follows reported blood flow distribution in the equine lung.
Abstract: Exercise-induced pulmonary hemorrhage (EIPH), which has been reported in humans and a variety of domestic animals following strenuous exercise, is most often documented in racehorses. Remodeling of pulmonary veins (VR) in equine EIPH was recently described, suggesting that it contributes to the pathogenesis of the disease. The cause of VR is unknown. We tested the hypothesis that the development of VR follows pulmonary blood flow distribution, preferentially occurring in the caudodorsal lung region. Furthermore, we hypothesized that VR underpins development of the other lesions of EIPH pathology. The lungs of 10 EIPH-affected horses and 8 controls were randomly sampled for histopathology (2,520 samples) and blindly scored for presence and severity of VR, hemosiderin (H), and interstitial fibrosis (IF). Mean sample score (MSS), mean lesion score, and percent samples with lesions were determined in four dorsal and three ventral lung regions, and the frequency, spatial distribution, and severity of lesions were determined. MSS for VR and H were significantly greater dorsally than ventrally (P < 0.001) and also decreased significantly in the caudocranial direction (P < 0.001). IF decreased only in the caudocranial direction. The percent samples with lesions followed the same distribution as MSS. VR often was accompanied by H; IF never occurred without VR and H. Similarity of the distribution of EIPH lesions and the reported fractal distribution of pulmonary blood flow suggests that VR develops in regions of high blood flow. Further experiments are necessary to determine whether VR is central to the pathogenesis of EIPH.
Publication Date: 2013-01-31 PubMed ID: 23372148DOI: 10.1152/japplphysiol.01170.2012Google Scholar: Lookup
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- Journal Article
Summary
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The research investigates the cause and development of a disease called Exercise-induced pulmonary hemorrhage (EIPH) in horses, with a focus on how the remodeling of pulmonary veins in the lungs relates to the disease and its progression. The team hypothesized that this remodeling might be related to where blood flow is greatest in the horses’ lungs.
Study Details and Methodology
- The researchers examined the lungs of 10 horses known to be suffering from EIPH, as well as those of 8 control horses.
- Taking a total of 2,520 samples from various regions of the lung, the team then conducted histopathology, a microscopic examination of the tissues, on these samples.
- The samples were scored for the presence and severity of pulmonary vein remodeling (VR), hemosiderin (H, iron-containing compound deposits) and interstitial fibrosis (IF, scar or fiber-like tissue).
Findings
- The mean sample score (MSS), which quantified the extent or frequency of lesions and the severity of the lesions, was found to be significantly higher in the rear upper (dorsal) part of the lung compared to the front lower (ventral) part of the lung. This suggests more severe alterations occur in those regions.
- The percentage of samples containing lesions followed the same distribution as the MSS, suggesting that areas with greater blood flow experienced more severe changes due to exercise.
- It was also observed that VR was often accompanied by hemosiderin, and interstitial fibrosis never occurred without the other two factors. This indicates a possible relationship where VR and hemosiderin contribute to the development of interstitial fibrosis.
Conclusions and Recommendations
- The researchers discovered that the distribution of lesions in horses with EIPH closely follows areas of high blood flow within the lung, suggesting VR may occur in regions of high blood flow.
- This evidence suggests that VR may be crucial to the development of EIPH in horses, but the researchers conclude that further experiments are required to confirm this hypothesis and fully understand the pathogenesis of EIPH.
Cite This Article
APA
Williams KJ, Robinson NE, Defeijter-Rupp H, Millerick-May M, Stack A, Hauptman J, Derksen FJ.
(2013).
Distribution of venous remodeling in exercise-induced pulmonary hemorrhage of horses follows reported blood flow distribution in the equine lung.
J Appl Physiol (1985), 114(7), 869-878.
https://doi.org/10.1152/japplphysiol.01170.2012 Publication
Researcher Affiliations
- Department of Pathobiology, Michigan State University, East Lansing, MI, USA.
MeSH Terms
- Animals
- Blood Flow Velocity
- Hemorrhage / etiology
- Hemorrhage / pathology
- Hemorrhage / physiopathology
- Hemorrhage / veterinary
- Horse Diseases / etiology
- Horse Diseases / pathology
- Horse Diseases / physiopathology
- Horses
- Lung Diseases / etiology
- Lung Diseases / pathology
- Lung Diseases / physiopathology
- Lung Diseases / veterinary
- Physical Conditioning, Animal / adverse effects
- Pulmonary Circulation
- Pulmonary Veins / pathology
- Pulmonary Veins / physiopathology
Citations
This article has been cited 9 times.- Rocchigiani G, Verin R, Uzal FA, Singer ER, Pregel P, Ressel L, Ricci E. Pulmonary bleeding in racehorses: A gross, histologic, and ultrastructural comparison of exercise-induced pulmonary hemorrhage and exercise-associated fatal pulmonary hemorrhage.. Vet Pathol 2022 Nov;59(6):973-982.
- Karagianni AE, Kurian D, Cillán-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.
- Duke JW, Lewandowski AJ, Abman SH, Lovering AT. Physiological aspects of cardiopulmonary dysanapsis on exercise in adults born preterm.. J Physiol 2022 Feb;600(3):463-482.
- 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).
- Ceriotti S, Bullone M, Leclere M, Ferrucci F, Lavoie JP. Severe asthma is associated with a remodeling of the pulmonary arteries in horses.. PLoS One 2020;15(10):e0239561.
- Blott S, Cunningham H, Malkowski L, Brown A, Rauch C. A Mechanogenetic Model of Exercise-Induced Pulmonary Haemorrhage in the Thoroughbred Horse.. Genes (Basel) 2019 Nov 1;10(11).
- Poole DC, Erickson HH. Exercise-induced pulmonary hemorrhage: where are we now?. Vet Med (Auckl) 2016;7:133-148.
- Kim DS, Lee M, Kwon OJ, Jeong I, Son JW, Na MJ, Kwon SJ. A 45-Year-Old Man With Recurrent Dyspnea and Hemoptysis during Exercise: Exercise-Induced Pulmonary Hemorrhage/Edema.. Tuberc Respir Dis (Seoul) 2015 Oct;78(4):375-9.
- Hinchcliff KW, Couetil LL, Knight PK, Morley PS, Robinson NE, Sweeney CR, van Erck E. Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement.. J Vet Intern Med 2015 May-Jun;29(3):743-58.
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