FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Journal of veterinary internal medicine2026; 40(3); aalag109; doi: 10.1093/jvimsj/aalag109

Evaluation of oxidative stress in ill neonatal foals: a preliminary study.

Abstract: Oxidative stress both contributes to and results from sepsis pathophysiology, but its role in ill foals remains poorly characterized. Objective: Ill foals will exhibit decreased antioxidant defense activity and increased oxidative products compared with healthy foals, and these changes will be associated with higher sepsis scores, lower survival scores, and non-survival. Methods: Twenty-six foals < 14 days old: 16 hospitalized foals (11 sick non-septic, 5 septic; median age, 1.5 days; range 1-13) and 10 healthy Standardbred foals (2 days old). Nine of 16 ill foals survived to discharge. Methods: Prospective multicenter cohort study. Ill foals were sampled at admission and every 24 h; healthy foals were sampled once at 48 h. Plasma paraoxonase (POase), arylesterase (AREase), superoxide dismutase (SOD), butyrylcholinesterase (BTChE), glutathione S-transferase (GST), glutathione peroxidase (GPx), total antioxidant capacity (TAC), and lipid peroxidation (LPO) were measured. Associations with sepsis score, survival score, and outcome were evaluated using generalized linear mixed models. Results: At admission, ill foals had lower SOD, GPx, BTChE, and GST and higher LPO compared with healthy foals (P ≤ .01). Non-survivors had lower POase (P = .01), SOD (P = .04), BTChE (P < .001), GST (P = .04), and GPx (P = .01) and higher LPO (P = .01). In mixed models, SOD, BTChE, and TAC were associated with both sepsis and survival score (P < .001). Arylesterase and POase were associated with sepsis score (P < .001). Conclusions: Ill neonatal foals had decreased antioxidant activity and increased oxidative products. Some biomarkers were associated with clinical scores and outcome, supporting further investigation of their potential clinical relevance.
© The Author(s) 2026. Published by Oxford University Press on behalf of the American College of Veterinary Internal Medicine.
Get Full Text
Publication Date: 2026-06-12 PubMed ID: 42284441PubMed Central: PMC13262654DOI: 10.1093/jvimsj/aalag109Google 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.
LinkedInCopy
  • Journal Article
  • Multicenter Study

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.

Objective Overview

  • This study investigated oxidative stress in ill neonatal foals by comparing antioxidant enzyme activity and oxidative damage markers between sick and healthy foals.
  • The researchers aimed to understand how oxidative stress relates to sepsis severity and survival outcomes in these foals.

Background and Rationale

  • Oxidative stress occurs when there is an imbalance between free radicals (oxidants) and the body’s ability to neutralize them with antioxidants.
  • Sepsis, a serious infection triggering systemic inflammation, is known to both cause and result from oxidative stress in human and veterinary medicine.
  • Although oxidative stress is known to play a role in sepsis pathophysiology, its role in sick neonatal foals has been poorly characterized prior to this study.
  • Neonatal foals, especially those less than 14 days old, are vulnerable to infections like sepsis and associated oxidative damage, which may impact survival.

Study Design and Methods

  • This was a prospective, multicenter cohort study involving a total of 26 foals less than 14 days old.
  • Participants were divided into two groups:
    • 16 hospitalized ill foals: subdivided into 11 sick non-septic foals and 5 septic foals, median age 1.5 days (range 1–13 days).
    • 10 healthy Standardbred foals aged 2 days, serving as controls.
  • Among the ill foals, 9 survived until hospital discharge, and 7 did not, allowing survival comparisons.
  • Samples were collected at admission and every 24 hours from ill foals, vs. a single sample at 48 hours for healthy foals.
  • Plasma biomarkers assessed included:
    • Antioxidant enzymes: paraoxonase (POase), arylesterase (AREase), superoxide dismutase (SOD), butyrylcholinesterase (BTChE), glutathione S-transferase (GST), glutathione peroxidase (GPx).
    • Total antioxidant capacity (TAC) to measure overall antioxidant status.
    • Lipid peroxidation (LPO) as an indicator of oxidative damage to lipids.
  • Clinical scoring was used:
    • Sepsis score to quantify disease severity.
    • Survival score to predict likelihood of survival.
  • Associations between biomarkers and clinical scores/outcomes were analyzed using generalized linear mixed models, a statistical method to handle repeated measures and complex data structures.

Key Findings

  • At admission, ill foals showed significantly:
    • Lower activity of antioxidant enzymes SOD, GPx, BTChE, and GST compared to healthy foals (p ≤ 0.01).
    • Higher lipid peroxidation (LPO), indicating increased oxidative damage (p ≤ 0.01).
  • Comparing survivors to non-survivors among ill foals:
    • Non-survivors had significantly lower levels of POase (p = 0.01), SOD (p = 0.04), BTChE (p < 0.001), GST (p = 0.04), and GPx (p = 0.01).
    • Non-survivors had higher LPO (p = 0.01), suggesting more oxidative damage.
  • Mixed model analysis revealed:
    • SOD, BTChE, and TAC were strongly associated with both sepsis and survival scores (p < 0.001), indicating these markers reflect disease severity and prognosis.
    • AREase and POase enzyme levels correlated significantly with sepsis score (p < 0.001), suggesting they also relate to illness severity.

Conclusions and Clinical Relevance

  • The study demonstrates that ill neonatal foals have diminished antioxidant defenses and elevated oxidative stress compared to healthy foals.
  • Greater oxidative stress was linked to increased sepsis severity and poorer survival outcomes.
  • Certain plasma biomarkers (SOD, BTChE, TAC, AREase, POase) showed promise for assessing illness severity and predicting survival in septic foals.
  • These findings support further research into oxidative stress biomarkers as potential clinical tools for early diagnosis, monitoring, and prognostic evaluation of sick foals.
  • Improving our understanding of oxidative stress in septic neonatal foals could guide therapeutic strategies, such as antioxidant supplementation or targeted treatments to reduce oxidative damage and improve survival.

Cite This Article

APA
Bindi F, Cingottini D, de Marchi L, Sala G, Vitale V, Sgorbini M. (2026). Evaluation of oxidative stress in ill neonatal foals: a preliminary study. J Vet Intern Med, 40(3), aalag109. https://doi.org/10.1093/jvimsj/aalag109

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: England
Language: English
Volume: 40
Issue: 3
PII: aalag109

Researcher Affiliations

Bindi, Francesca
  • Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa 56122, Italy.
Cingottini, Dania
  • Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa 56122, Italy.
de Marchi, Lucia
  • Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa 56122, Italy.
Sala, Giulia
  • Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa 56122, Italy.
Vitale, Valentina
  • Hospital Clínico Veterinario, Universidad CEU-Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia 46115, Spain.
Sgorbini, Micaela
  • Department of Veterinary Science, University of Pisa, San Piero a Grado, Pisa 56122, Italy.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / metabolism
  • Horse Diseases / blood
  • Oxidative Stress / physiology
  • Sepsis / veterinary
  • Sepsis / metabolism
  • Sepsis / blood
  • Animals, Newborn
  • Female
  • Aryldialkylphosphatase / blood
  • Carboxylic Ester Hydrolases / blood
  • Male
  • Prospective Studies
  • Lipid Peroxidation
  • Superoxide Dismutase / blood
  • Antioxidants / metabolism
  • Glutathione Transferase / blood
  • Glutathione Peroxidase / blood
  • Butyrylcholinesterase / blood
  • Biomarkers / blood

Conflict of Interest Statement

The authors declare no conflicts of interest.

References

This article includes 43 references
  1. Eaton S. Neonatal sepsis—pathology and clinical signs. Equine Vet Educ 2023;35:498-503.
    doi: 10.1111/eve.13796google scholar: lookup
  2. Poggi C, Dani C. Sepsis and oxidative stress in the newborn: from pathogenesis to novel therapeutic targets. Oxid Med Cell Longev 2018;2018:9390140.
    doi: 10.1155/2018/9390140pmc: PMC6098933pubmed: 30174784google scholar: lookup
  3. Sahoo DK, Wong D, Patani A. Exploring the role of antioxidants in sepsis-associated oxidative stress: a comprehensive review. Front Cell Infect Microbiol 2024;14:14.
    doi: 10.3389/fcimb.2024.1348713pmc: PMC10952105pubmed: 38510969google scholar: lookup
  4. Joffre J, Hellman J. Oxidative stress and endothelial dysfunction in sepsis and acute inflammation. Antioxid Redox Signal 2021;35:1291-1307.
    doi: 10.1089/ars.2021.0027pubmed: 33637016google scholar: lookup
  5. Perrone S, Tataranno ML, Negro S. Early identification of the risk for free radical-related diseases in preterm newborns. Early Hum Dev 2010;86:241-244.
    doi: 10.1016/j.earlhumdev.2010.03.008pubmed: 20466493google scholar: lookup
  6. Halliwell B, Gutteridge JMC. Free Radicals in Biology and Medicine. .
    doi: 10.1093/acprof:oso/9780198717478.001.0001google scholar: lookup
  7. Ceron JJ, Tecles F, Tvarijonaviciute A. Serum paraoxonase 1 (PON1) measurement: an update. BMC Vet Res 2014;10:74.
    doi: 10.1186/1746-6148-10-74pmc: PMC3985595pubmed: 24666514google scholar: lookup
  8. Vernaccini M, Meucci V, Bindi F. PON1 enzyme activity assays for serum and heparinized plasma in horses and stability evaluation of the enzyme activity over different freeze-thaw cycles and mimic transportation. Res Vet Sci 2024;177:105352.
    doi: 10.1016/j.rvsc.2024.105352pubmed: 38996659google scholar: lookup
  9. Palmieri B, Sblendorio V. Oxidative stress tests: overview on reliability and use. Part I. Eur Rev Med Pharmacol Sci 2007;11:309-342.
    pubmed: 18074940
  10. Marañón G, Manley W, Cayado P, García C, de la Muela MS, Vara E. Alterations in the glutathione metabolism could be implicated in the ischemia-induced small intestinal cell damage in horses. BMC Vet Res 2009;5:10.
    doi: 10.1186/1746-6148-5-10pmc: PMC2664797pubmed: 19296836google scholar: lookup
  11. Mårtensson J, Jain A, Meister A. Glutathione is required for intestinal function. Proc Natl Acad Sci U S A 1990;87:1715-1719.
    doi: 10.1073/pnas.87.5.1715pmc: PMC53553pubmed: 2308931google scholar: lookup
  12. Ho E, Karimi Galougahi K, Liu CC, Bhindi R, Figtree GA. Biological markers of oxidative stress: applications to cardiovascular research and practice. Redox Biol 2013;1:483-491.
    doi: 10.1016/j.redox.2013.07.006pmc: PMC3830063pubmed: 24251116google scholar: lookup
  13. Haghnazari L, Vaisi-Raygani A, Keshvarzi F. Effect of acetylcholinesterase and butyrylcholinesterase on intrauterine insemination, contribution to inflammations, oxidative stress and antioxidant status; a preliminary report. J Reprod Infertil 2016;17:157-162.
    pmc: PMC4947203pubmed: 27478769
  14. Fazekaš T, Kováčik L, Rad MM. Serum butyrylcholinesterase activity as a predictor of severity and mortality in COVID-19 patients. Sci Rep 2025;15:23437.
    doi: 10.1038/s41598-025-07017-2pmc: PMC12222779pubmed: 40604014google scholar: lookup
  15. Goliasch G, Haschemi A, Marculescu R. Butyrylcholinesterase activity predicts long-term survival in patients with coronary artery disease. Clin Chem 2012;58:1055-1058.
    doi: 10.1373/clinchem.2011.175984pubmed: 22294734google scholar: lookup
  16. Ben Anes A, Ben Nasr H, Garrouch A. Alterations in acetylcholinesterase and butyrylcholinesterase activities in chronic obstructive pulmonary disease: relationships with oxidative and inflammatory markers. Mol Cell Biochem 2018;445:1-11.
    doi: 10.1007/s11010-017-3246-zpubmed: 29234928google scholar: lookup
  17. Klocker EV, Barth DA, Riedl JM. Decreased activity of circulating butyrylcholinesterase in blood is an independent prognostic marker in pancreatic cancer patients. Cancers (Basel) 2020;12:1154.
    doi: 10.3390/cancers12051154pmc: PMC7281496pubmed: 32375339google scholar: lookup
  18. Santarpia L, Grandone I, Contaldo F, Pasanisi F. Butyrylcholinesterase as a prognostic marker: a review of the literature. J Cachexia Sarcopenia Muscle 2012;4:31-39.
    doi: 10.1007/s13539-012-0083-5pmc: PMC3581611pubmed: 22956442google scholar: lookup
  19. Bosmann M, Ward PA. The inflammatory response in sepsis. Trends Immunol 2013;34:129-136.
    doi: 10.1016/j.it.2012.09.004pmc: PMC3543471pubmed: 23036432google scholar: lookup
  20. Wong D, Sahoo DK, Faivre C. Oxidative stress in critically ill neonatal foals. J Vet Intern Med 2025;39:e17297.
    doi: 10.1111/jvim.17297pmc: PMC11758150pubmed: 39854109google scholar: lookup
  21. Wong DM, Ruby RE, Dembek KA. Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates. J Vet Intern Med 2018;32:1185-1193.
    doi: 10.1111/jvim.15087pmc: PMC5980351pubmed: 29582480google scholar: lookup
  22. Bohlin A, Saegerman C, Hoeberg E. Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission. J Vet Intern Med 2019;33:1507-1513.
    doi: 10.1111/jvim.15487pmc: PMC6524090pubmed: 31004404google scholar: lookup
  23. Li Y, Zhai R, Li H, Mei X, Qiu G. Prognostic value of serum paraoxonase and arylesterase activity in patients with sepsis. J Int Med Res 2013;41:681-687.
    doi: 10.1177/0300060513483412pubmed: 23637274google scholar: lookup
  24. Ayar G, Atmaca YM, Alışık M, Erel Ö. Effects of paraoxonase, arylesterase, ceruloplasmin, catalase, and myeloperoxidase activities on prognosis in pediatric patients with sepsis. Clin Biochem 2017;50:414-417.
    doi: 10.1016/j.clinbiochem.2016.12.013pubmed: 28167245google scholar: lookup
  25. Scavone D, Sgorbini M, Borges AS, Oliveira-Filho JP, Vitale V, Paltrinieri S. Serial measurements of paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia. BMC Vet Res 2020;16:422.
    doi: 10.1186/s12917-020-02629-4pmc: PMC7641807pubmed: 33148245google scholar: lookup
  26. Kumar S, Gupta E, Kaushik S, Kumar Srivastava V, Mehta S, Jyoti A. Evaluation of oxidative stress and antioxidant status: correlation with the severity of sepsis. Scand J Immunol 2018;87:e12653.
    doi: 10.1111/sji.12653pubmed: 29484685google scholar: lookup
  27. Koptan A, Ghanem PM, Abdel-Raof Y, Elkhaiat H, Helal M. Clinical and hematobiochemical changes in foals and adult horses with upper and lower respiratory tract affections. Egypt J Vet Sci 2024;56:979–991.
    doi: 10.21608/ejvs.2024.277268.1939google scholar: lookup
  28. Schneider MP, Sullivan JC, Wach PF. Protective role of extracellular superoxide dismutase in renal ischemia/reperfusion injury. Kidney Int 2010;78:374-381.
    doi: 10.1038/ki.2010.141pmc: PMC3888358pubmed: 20505656google scholar: lookup
  29. Hajimohammadi S, Lockridge O, Masson P. New views on physiological functions and regulation of butyrylcholinesterase and potential therapeutic interventions. Front Mol Biosci 2025;12:12.
    doi: 10.3389/fmolb.2025.1625318pmc: PMC12221946pubmed: 40612057google scholar: lookup
  30. Biolo G, Antonione R, De Cicco M. Glutathione metabolism in sepsis. Crit Care Med 2007;35:S591-S595.
    doi: 10.1097/01.CCM.0000278913.19123.13pubmed: 17713414google scholar: lookup
  31. Tandon R, Tandon A. Unraveling the multifaceted role of glutathione in sepsis: a comprehensive review. Cureus 2024;16:e56896.
    doi: 10.7759/cureus.56896pmc: PMC11042744pubmed: 38659506google scholar: lookup
  32. Huet O, Cherreau C, Nicco C. Pivotal role of glutathione depletion in plasma-induced endothelial oxidative stress during sepsis. Crit Care Med 2008;36:2328-2334.
    doi: 10.1097/CCM.0b013e3181800387pubmed: 18664787google scholar: lookup
  33. Furr M, Frellstedt L, Geor R. Sick neonatal foals do not demonstrate evidence of oxidative stress. J Equine Vet Sci 2012;32:297-299.
    doi: 10.1016/j.jevs.2011.11.004google scholar: lookup
  34. Lorente L, Martín MM, Abreu-González P. Sustained high serum malondialdehyde levels are associated with severity and mortality in septic patients. Crit Care 2013;17:R290.
    doi: 10.1186/cc13155pmc: PMC4055989pubmed: 24326199google scholar: lookup
  35. Batra S, Kumar R, Seema KAK, Ray G. Alterations in antioxidant status during neonatal sepsis. Ann Trop Paediatr 2000;20:27-33.
    doi: 10.1080/02724930092039pubmed: 10824210google scholar: lookup
  36. Weiss SL, Deutschman CS. Elevated malondialdehyde levels in sepsis—something to “stress” about?. Crit Care 2014;18:125.
    doi: 10.1186/cc13786pmc: PMC4056888pubmed: 25029036google scholar: lookup
  37. Shukeri WFWM, Ralib AM, Abdulah NZ, Mat-Nor MB. Sepsis mortality score for the prediction of mortality in septic patients. J Crit Care 2018;43:163-168.
    doi: 10.1016/j.jcrc.2017.09.009pubmed: 28903084google scholar: lookup
  38. Karapetsa M, Pitsika M, Goutzourelas N, Stagos D, Tousia Becker A, Zakynthinos E. Oxidative status in ICU patients with septic shock. Food Chem Toxicol 2013;61:106-111.
    doi: 10.1016/j.fct.2013.03.026pubmed: 23542126google scholar: lookup
  39. Hsiao SY, Kung CT, Su CM. Impact of oxidative stress on treatment outcomes in adult patients with sepsis. Medicine 2020;99:e20872.
    doi: 10.1097/MD.0000000000020872pmc: PMC7328964pubmed: 32590792google scholar: lookup
  40. Semedi BP, Rehatta NM, Nugraha J, Soetjipto. Antioxidant role in critically ill patients with vasodilatory shock: does glutathione peroxidase correlate to severity of tissue hypoxia and organ failure. Open Access Emerg Med 2023;15:133-143.
    doi: 10.2147/OAEM.S407958pmc: PMC10155716pubmed: 37151382google scholar: lookup
  41. Kim JS, Kwon WY, Suh GJ. Plasma glutathione reductase activity and prognosis of septic shock. J Surg Res 2016;200:298-307.
    doi: 10.1016/j.jss.2015.07.044pubmed: 26316444google scholar: lookup
  42. Mantzarlis K, Tsolaki V, Zakynthinos E. Role of oxidative stress and mitochondrial dysfunction in sepsis and potential therapies. Oxid Med Cell Longev 2017;2017:5985209.
    doi: 10.1155/2017/5985209pmc: PMC5585571pubmed: 28904739google scholar: lookup
  43. Migliorisi A, Hart K, Vaughn S, Austin S, Aldridge B, Wilkins P. Plasma ascorbic acid, antioxidant capacity, and reactive oxygen species in healthy foals. Am J Vet Res 2022;83:ajvr.22.02.0025.
    doi: 10.2460/ajvr.22.02.0025pubmed: 35895767google scholar: lookup

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 106,643 horse owners like you who receive our email updates on horse health and nutrition.