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Journal of veterinary internal medicine2021; 35(6); 2912-2919; doi: 10.1111/jvim.16294

Randomized, controlled trial comparing Rhodococcus equi and poly-N-acetyl glucosamine hyperimmune plasma to prevent R equi pneumonia in foals.

Abstract: Hyperimmune plasma raised against β-1→6-poly-N-acetyl glucosamine (PNAG HIP) mediates more opsonophagocytic killing of Rhodococcus equi (R equi) than does R equi hyperimmune plasma (RE HIP) in vitro. The relative efficacy of PNAG HIP and RE HIP to protect foals against R equi pneumonia, however, has not been evaluated. Objective: Transfusion with PNAG HIP will be superior to RE HIP in foals for protection against R equi pneumonia in a randomized, controlled, blinded clinical trial. Methods: Four hundred sixty Quarter Horse and Thoroughbred foals at 5 large breeding farms in the United States. Methods: A randomized, controlled, blinded clinical trial was conducted in which foals were transfused within 24 hours after birth with 2 L of either RE HIP or PNAG HIP. Study foals were monitored through weaning for clinical signs of pneumonia by farm veterinarians. The primary outcome was the proportion of foals that developed pneumonia after receiving each type of plasma. Results: The proportion of foals that developed pneumonia was the same between foals transfused with RE HIP (14%; 32/228) and PNAG HIP (14%; 30/215). Conclusions: Results indicate that PNAG HIP was not superior to a commercially available, United States Department of Agriculture-licensed RE HIP product for protecting foals against R equi pneumonia under field conditions.
Publication Date: 2021-11-05 PubMed ID: 34738651PubMed Central: PMC8692225DOI: 10.1111/jvim.16294Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

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The research article is discussing the relative effectiveness of two different types of hyperimmune plasma, Rhodococcus equi hyperimmune plasma (RE HIP) and poly-N-acetyl glucosamine hyperimmune plasma (PNAG HIP), in protecting foals against bacterial pneumonia caused by Rhodococcus equi.

Objective of the Study

  • The main objective of the study was to evaluate whether transfusions of PNAG HIP would be more effective in protecting foals against Rhodococcus equi pneumonia than RE HIP. This evaluation was done through a randomized, controlled, and blinded clinical trial.

Methods Used

  • The trial included 460 Quarter Horse and Thoroughbred foals from 5 large breeding farms in the United States.
  • Within 24 hours after birth, the foals were transfused with 2 litres of either RE HIP or PNAG HIP.
  • The foals were monitored through weaning for clinical signs of pneumonia by farm veterinarians. The main outcome the researchers were observing was the proportion of foals that developed pneumonia after receiving each type of plasma.

Results of the Study

  • The results demonstrated that the proportion of foals that developed pneumonia was the same for both groups. 14% of foals (or 32 out of 228) that received RE HIP developed pneumonia, and the same percentage (or 30 out of 215 foals) that received PNAG HIP also developed the condition.

Conclusions of the Study

  • Based on these results, the researchers concluded that PNAG HIP is not superior to a commercially available, RE HIP product licensed by the United States Department of Agriculture (USDA) in protecting foals against Rhodococcus equi pneumonia under field conditions. This means that the existing treatment method using RE HIP remains as effective as the new treatment method using PNAG HIP, and therefore no change in clinical practice is warranted based on this trial’s results.

Cite This Article

APA
Kahn SK, Cywes-Bentley C, Blodgett GP, Canaday NM, Turner-Garcia CE, Flores-Ahlschwede P, Metcalfe LL, Nevill M, Vinacur M, Sutter PJ, Meyer SC, Bordin AI, Pier GB, Cohen ND. (2021). Randomized, controlled trial comparing Rhodococcus equi and poly-N-acetyl glucosamine hyperimmune plasma to prevent R equi pneumonia in foals. J Vet Intern Med, 35(6), 2912-2919. https://doi.org/10.1111/jvim.16294

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 35
Issue: 6
Pages: 2912-2919

Researcher Affiliations

Kahn, Susanne K
  • Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Cywes-Bentley, Colette
  • Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Blodgett, Glenn P
  • 6666 Ranch, Guthrie, Texas, USA.
Canaday, Nathan M
  • 6666 Ranch, Guthrie, Texas, USA.
Turner-Garcia, Carly E
  • Lazy E Ranch, Guthrie, Oklahoma, USA.
Flores-Ahlschwede, Patricia
  • Rood & Riddle Equine Hospital in Saratoga, Saratoga Springs, New York, USA.
Metcalfe, Laurie L
  • Rood & Riddle Equine Hospital, Lexington, Kentucky, USA.
Nevill, Mark
  • Granada Farms, Wheelock, Texas, USA.
Vinacur, Mariana
  • Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Sutter, Patrick J
  • Mg Biologics, Inc, Ames, Iowa, USA.
Meyer, Sarah C
  • Mg Biologics, Inc, Ames, Iowa, USA.
Bordin, Angela I
  • Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Pier, Gerald B
  • Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Cohen, Noah D
  • Equine Infectious Disease Laboratory, Department of Large Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

MeSH Terms

  • Acetylglucosamine
  • Actinomycetales Infections / prevention & control
  • Actinomycetales Infections / veterinary
  • Animals
  • Antibodies, Bacterial
  • Horse Diseases / prevention & control
  • Horses
  • Pneumonia, Bacterial / prevention & control
  • Pneumonia, Bacterial / veterinary
  • Rhodococcus equi

Grant Funding

  • Grayson-Jockey Club Research Foundation
  • Link Equine Research Endowment, Equine Infectious Disease Epidemiology Program

Conflict of Interest Statement

Gerald B. Pier is an inventor of intellectual properties (human monoclonal antibody to PNAG and PNAG vaccines) that are licensed by Brigham and Women\'s Hospital to Alopexx Inc, an entity in which Gerald B. Pier also holds equity. As an inventor of intellectual properties, Gerald B. Pier also has the right to receive a share of licensing‐related income (royalties, fees) through Brigham and Women\'s Hospital from Alopexx Inc. Gerald B. Pier\'s interests were reviewed and are managed by the Brigham and Women\'s Hospital and Partners Health care in accordance with their conflict of interest policies. Colette Cywes‐Bentley is an inventor of intellectual properties (use of human monoclonal antibody to PNAG and use of PNAG vaccines) that are licensed by Brigham and Women\'s Hospital to Alopexx Inc. As an inventor of intellectual properties, Colette Cywes‐Bentley also has the right to receive a share of licensing‐related income (royalties, fees) through Brigham and Women\'s Hospital from Alopexx Inc. Sarah C. Meyer and Patrick J. Sutter work for MG Biologics that produced the plasma used for this project and thus might have potential earnings from plasma sales, but they had no part in the study design other than masking plasma and did not participate in data analysis. No other authors have a conflict of interest.

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