Endothelial glycocalyx degradation in critically ill foals.
Abstract: Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals. Objective: Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals. Methods: Ninety foals ≤3 days old. Methods: Prospective, multicenter, longitudinal study. Foals were categorized into hospitalized (n = 74; 55 septic; 19 sick nonseptic) and 16 healthy foals. Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were measured over 72 hours using immunoassays. Results: Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were significantly higher in hospitalized and septic than healthy foals (P < .05). Serum (ANG-2) and plasma (ANP) were significantly higher in hospitalized nonsurvivors than in survivors (P < .05). On admission, hospitalized foals with serum (HS) > 58.7 ng/mL had higher odds of nonsurvival (odds ratio [OR] = 6.1; 95% confidence interval [CI] = 1.02-36.7). Plasma (ANP) >11.5 pg/mL was associated with the likelihood of nonsurvival in hospitalized foals (OR = 7.2; 95% CI = 1.4-37.4; P < .05). Septic foals with serum (ANG-2) >1018 pg/mL on admission had higher odds of nonsurvival (OR = 6.5; 95% CI =1.2-36.6; P < .05). Conclusions: Critical illness in newborn foals is associated with EG degradation and injury, and these biomarkers are related to the severity of disease on admission and the outcome of sick foals.
© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2024-09-14 PubMed ID: 39275920PubMed Central: PMC11423458DOI: 10.1111/jvim.17196Google Scholar: Lookup
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- Journal Article
- Multicenter Study
- Observational Study
- Veterinary
Summary
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Overview
- This study investigates the degradation of the endothelial glycocalyx (EG) in critically ill newborn foals and examines several blood biomarkers related to EG injury, assessing their associations with disease severity and survival outcomes.
Background
- The endothelial glycocalyx (EG) is a protective layer lining blood vessels, playing a key role in vascular health.
- In human sepsis, EG degradation occurs and fragments released during this damage can serve as biomarkers indicating endothelial injury.
- There is limited knowledge about EG degradation biomarkers in foals, particularly how these biomarkers relate to disease severity and survival in hospitalized foals.
Objectives of the Study
- To measure concentrations of specific biomarkers in the blood of newborn foals, namely:
- Syndecan-1 (SDC-1)
- Heparan sulfate (HS)
- Angiopoietin-2 (ANG-2)
- Aldosterone (ALD)
- Atrial natriuretic peptide (ANP)
- To determine associations between these biomarkers and:
- The severity of illness in foals
- The likelihood of survival or death
Study Design and Methods
- Ninety foals aged 3 days or younger participated in a prospective, multicenter, longitudinal study.
- Foals were grouped into:
- Hospitalized foals (n=74), which included:
- Septic foals (n=55)
- Sick, nonseptic foals (n=19)
- Healthy foals (n=16)
- Blood samples were collected and analyzed over 72 hours using immunoassays to measure:
- Serum levels of SDC-1, HS, ANG-2, ALD
- Plasma levels of ANP
Key Results
- Biomarker Levels:
- Hospitalized and septic foals had significantly higher serum levels of SDC-1, HS, ANG-2, ALD, and plasma ANP compared to healthy foals (P < .05).
- Association with Survival:
- Hospitalized foals that did not survive had significantly higher serum ANG-2 and plasma ANP compared to survivors (P < .05).
- On admission, foals with serum HS levels above 58.7 ng/mL had 6.1 times higher odds of not surviving (95% CI: 1.02-36.7).
- Foals with plasma ANP levels above 11.5 pg/mL had 7.2 times higher odds of nonsurvival (95% CI: 1.4-37.4; P<.05).
- Among septic foals, those with serum ANG-2 levels over 1018 pg/mL had 6.5 times higher odds of dying (95% CI: 1.2-36.6; P<.05).
Conclusions and Implications
- Endothelial glycocalyx degradation occurs in critically ill newborn foals, particularly those hospitalized with sepsis.
- The elevated concentrations of EG biomarkers are correlated with increased disease severity and a higher risk of death.
- These biomarkers (SDC-1, HS, ANG-2, ALD, ANP) can be used to evaluate endothelial injury in foals and may serve as important tools for prognosis.
- Monitoring these biomarkers on admission could help veterinarians identify foals at greater risk and guide therapeutic decision-making.
Significance of the Study
- This study adds valuable knowledge about EG degradation in veterinary medicine, specifically in neonatal foals.
- It provides baseline data for biomarker levels related to EG injury in healthy versus critically ill foals.
- It highlights the potential for these biomarkers to predict outcomes, which can improve clinical management of foal sepsis and other critical illnesses.
Cite This Article
APA
Gomez DE, Kamr A, Gilsenan WF, Burns TA, Mudge MC, Hostnik LD, Toribio RE.
(2024).
Endothelial glycocalyx degradation in critically ill foals.
J Vet Intern Med, 38(5), 2748-2757.
https://doi.org/10.1111/jvim.17196 Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
- Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
MeSH Terms
- Animals
- Female
- Male
- Angiopoietin-2 / blood
- Animals, Newborn / blood
- Atrial Natriuretic Factor / blood
- Biomarkers / blood
- Critical Illness
- Glycocalyx / metabolism
- Heparan Sulfate / blood
- Horse Diseases / blood
- Horse Diseases / mortality
- Horse Diseases / metabolism
- Horses
- Longitudinal Studies
- Prospective Studies
- Sepsis / veterinary
- Sepsis / blood
- Sepsis / mortality
- Syndecan-1 / blood
Grant Funding
- 055052 / Equine Guelph
Conflict of Interest Statement
Authors declare no conflict of interest.
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