Renin-Angiotensin-aldosterone system and hypothalamic-pituitary-adrenal axis in hospitalized newborn foals.
Abstract: The renin-angiotensin-aldosterone system (RAAS) and hypothalamic-pituitary-adrenal axis (HPAA) and their interactions during illness and hypoperfusion are important to maintain organ function. HPAA dysfunction and relative adrenal insufficiency (RAI) are common in septic foals. Information is lacking on the RAAS and mineralocorticoid response in the context of RAI in newborn sick foals. Objective: To investigate the RAAS, as well as HPAA factors that interact with the RAAS, in hospitalized foals, and to determine their association with clinical findings. We hypothesized that critical illness in newborn foals results in RAAS activation, and that inappropriately low aldosterone concentrations are part of the RAI syndrome of critically ill foals. Methods: A total of 167 foals ≤3 days of age: 133 hospitalized (74 septic, 59 sick nonseptic) and 34 healthy foals. Methods: Prospective, multicenter, cross-sectional study. Blood samples were collected on admission. Plasma renin activity (PRA) and angiotensin-II (ANG-II), aldosterone, ACTH, and cortisol concentrations were measured in all foals. Results: ANG-II, aldosterone, ACTH, and cortisol concentrations as well as ACTH/aldosterone and ACTH/cortisol ratios were higher in septic foals compared with healthy foals (P < .05). No difference in PRA between groups was found. High serum potassium and low serum chloride concentrations were associated with hyperaldosteronemia in septic foals. Conclusions: RAAS activation in critically ill foals is characterized by increased ANG-II and aldosterone concentrations. Inappropriately low cortisol and aldosterone concentrations defined as high ACTH/cortisol and ACTH/aldosterone ratios in septic foals suggest that RAI is not restricted to the zona fasciculata in critically ill newborn foals.
Copyright © 2013 by the American College of Veterinary Internal Medicine.
Publication Date: 2013-02-11 PubMed ID: 23398197DOI: 10.1111/jvim.12043Google 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.
- Journal Article
- Multicenter Study
- Research Support
- Non-U.S. Gov't
- Research Support
- U.S. Gov't
- Non-P.H.S.
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.
The research investigates the activities of the renin-angiotensin-aldosterone system (RAAS) and hypothalamic-pituitary-adrenal axis (HPAA), two key physiological systems, in critically ill newborn horses (foals). The researchers hypothesized that the RAAS and HPAA show specific changes in activity in response to illness and high ACTH/cortisol and ACTH/aldosterone ratios in sick foals suggest adrenal insufficiency isn’t only restricted to a part of the adrenal gland (zona fasciculata).
Context and Purpose of the Study
- The connection between the renin-angiotensin-aldosterone system (RAAS) and the hypothalamic-pituitary-adrenal axis (HPAA) is vital to maintaining organ function in states of illness and low blood perfusion.
- Modifications in these systems, including HPAA dysfunction and relative adrenal insufficiency (RAI), have been seen in sick foals, particularly those with sepsis. However, less established data exists regarding the RAAS role and the response of a hormone called aldosterone within the context of RAI in these clients.
- Thus, this study aimed to examine these factors and their possible associations with specific clinical findings in hospitalized foals, with the premise that these foals’ critical illnesses would lead to an overactive RAAS and abnormally low aldosterone levels as part of their RAI.
Research Methods
- The study utilized a prospective, multicenter, cross-sectional design, focusing on 167 foals aged three days or less. The subjects were divided into groups of 133 hospitalized foals, 74 of which had sepsis, and 59 were sick without sepsis, and 34 healthy foals.
- Blood samples were taken from all subjects on admission. Key markers and hormones related to the RAAS and HPAA, including Plasma Renin Activity (PRA), Angiotensin-II (ANG-II), aldosterone, Adrenocorticotropic Hormone (ACTH), and cortisol, were measured in each sample.
Key Findings
- The results showed that markers ANG-II, aldosterone, ACTH, and cortisol, as well as the ACTH/aldosterone and ACTH/cortisol ratios, were generally higher in septic foals than healthy ones.
- No significant difference was found in the PRA between the different groups.
- The data also suggested associations between high serum potassium and low serum chloride levels on one hand and excessive aldosterone levels (hyperaldosteronemia) on the other in septic foals.
Concluding Observations and Implications
- The study concluded that an activated RAAS in critically ill foals is marked by increased ANG-II and aldosterone concentrations.
- High ACTH/cortisol and ACTH/aldosterone ratios suggesting adrenal insufficiency in these foals were not limited to the zona fasciculata (a central region of the adrenal glands), contradicting previous beliefs.
- This finding could be significant in understanding and addressing the impact of critical illnesses on foals, possibly leading to improved treatment strategies.
Cite This Article
APA
Dembek KA, Onasch K, Hurcombe SD, MacGillivray KC, Slovis NM, Barr BS, Reed SM, Toribio RE.
(2013).
Renin-Angiotensin-aldosterone system and hypothalamic-pituitary-adrenal axis in hospitalized newborn foals.
J Vet Intern Med, 27(2), 331-338.
https://doi.org/10.1111/jvim.12043 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH.
MeSH Terms
- Adrenal Insufficiency / blood
- Adrenal Insufficiency / physiopathology
- Adrenal Insufficiency / veterinary
- Adrenocorticotropic Hormone / blood
- Aldosterone / blood
- Angiotensin II / blood
- Animals
- Animals, Newborn
- Case-Control Studies
- Cross-Sectional Studies
- Female
- Horse Diseases / blood
- Horse Diseases / physiopathology
- Horses
- Hydrocortisone / blood
- Hypothalamo-Hypophyseal System / physiology
- Male
- Pituitary-Adrenal System / physiology
- Prospective Studies
- Renin-Angiotensin System / physiology
- Sepsis / blood
- Sepsis / physiopathology
- Sepsis / veterinary
- Statistics, Nonparametric
- Survival Analysis
Citations
This article has been cited 12 times.- Elder E, Wong D, Johnson K, Robertson H, Marner M, Dembek K. Assessment of the hypothalamic-pituitary-adrenocortical axis function using a vasopressin stimulation test in neonatal foals.. J Vet Intern Med 2023 Sep-Oct;37(5):1881-1888.
- Johnson K, Peterson J, Kopper J, Dembek K. The hypothalamic-pituitary-adrenal axis response to ovine corticotropin-releasing-hormone stimulation tests in healthy and hospitalized foals.. J Vet Intern Med 2023 Jan;37(1):292-301.
- Lauteri E, Mariella J, Beccati F, Roelfsema E, Castagnetti C, Pepe M, Peric T, Barbato O, Montillo M, Rouge S, Freccero F. Adrenal Gland Ultrasonographic Measurements and Plasma Hormone Concentrations in Clinically Healthy Newborn Thoroughbred and Standardbred Foals.. Animals (Basel) 2021 Jun 19;11(6).
- Colmer SF, Luethy D, Abraham M, Stefanovski D, Hurcombe SD. Utility of cell-free DNA concentrations and illness severity scores to predict survival in critically ill neonatal foals.. PLoS One 2021;16(4):e0242635.
- Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE. Dynamics of androgens in healthy and hospitalized newborn foals.. J Vet Intern Med 2021 Jan;35(1):538-549.
- Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD. Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses.. J Vet Intern Med 2020 Nov;34(6):2710-2718.
- Aleman M, McCue PM, Chigerwe M, Madigan JE. Plasma concentrations of steroid precursors, steroids, neuroactive steroids, and neurosteroids in healthy neonatal foals from birth to 7 days of age.. J Vet Intern Med 2019 Sep;33(5):2286-2293.
- Dembek KA, Johnson LM, Timko KJ, Minuto JS, Hart KA, Barr BS, Toribio RE. Multiple adrenocortical steroid response to administration of exogenous adrenocorticotropic hormone to hospitalized foals.. J Vet Intern Med 2019 Jul;33(4):1766-1774.
- Agne GF, Jung SW, Wooldridge AA, Duran SH, Ravis W, Toribio R. Pharmacokinetic and pharmacodynamic properties of orally administered torsemide in healthy horses.. J Vet Intern Med 2018 Jul;32(4):1428-1435.
- Gomez DE, Biermann NM, Sanchez LC. Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in 793 Hospitalized Foals.. J Vet Intern Med 2015 Sep-Oct;29(5):1395-402.
- Dembek KA, Hurcombe SD, Frazer ML, Morresey PR, Toribio RE. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling.. PLoS One 2014;9(10):e109212.
- Toth B, Slovis NM, Constable PD, Taylor SD. Plasma adrenomedullin concentrations in critically ill neonatal foals.. J Vet Intern Med 2014 Jul-Aug;28(4):1294-300.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
