Analyze Diet
PloS one2023; 18(5); e0285819; doi: 10.1371/journal.pone.0285819

Use of admission serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations as a marker of sepsis and outcome in neonatal foals.

Abstract: Equine neonatal sepsis can be challenging to diagnose and prognosticate. Neutrophil gelatinase-associated lipocalin (NGAL), a new marker of renal damage and inflammation, can potentially be helpful. To evaluate NGAL in neonatal foals with sepsis, and assess its relation to outcome. Foals ≤ 14 days, with admission blood analysis and stored serum. NGAL was measured on stored serum from 91 foals. Foals were scored for sepsis and survival and categorized according to sepsis status (septic, sick non-septic, healthy, and uncertain sepsis status) and outcome groups (survivors and non-survivors). The septic foals were further sub-categorized according to severity (normal sepsis, severe sepsis and septic shock). A Kruskal-Wallis test was used to compare serum NGAL concentrations in survivors and non-survivors, in the sepsis status groups, and in the sepsis severity groups. Optimal cut-off values for serum NGAL concentrations to diagnose sepsis and outcome were determined with receiver operating characteristic (ROC) curves. NGAL was compared to creatinine and SAA. Median serum NGAL concentrations were significantly higher in septic than non-septic foals. However, serum NGAL concentrations did not differ between sepsis severity subgroups. Serum NGAL concentrations were significantly lower in survivors than in non-survivors. Optimal cut-off values of serum NGAL concentrations were 455 μg/L (sensitivity 71.4%, specificity 100%) and 1104 μg/L (sensitivity 39.3%, specificity 95.2%) for predicting sepsis and non-survival, respectively. NGAL correlated to SAA, but not to creatinine. NGAL performed similarly to SAA to diagnose sepsis. Serum NGAL concentrations may be useful for diagnosing sepsis and predicting outcome.
Publication Date: 2023-05-18 PubMed ID: 37200285PubMed Central: PMC10194986DOI: 10.1371/journal.pone.0285819Google 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

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.

This research study investigates the use of Neutrophil gelatinase-associated lipocalin (NGAL) as a marker to diagnose sepsis in newborn foals and predict their chance of survival. The study found that NGAL could potentially be a valuable tool for these purposes.

Research Method

  • The researchers used the serum of 91 newborn foals, all aged 14 days or less, and stored these samples.
  • The NGAL levels in the serum were measured, and the foals were categorised based on the sepsis status (septic, sick non-septic, healthy, and uncertain sepsis status) and outcome groups (survivors and non-survivors).
  • Septic foals were further divided into subgroups of severity (normal sepsis, severe sepsis, and septic shock).
  • A Kruskal-Wallis test was used to compare NGAL concentrations in survivors and non-survivors, sepsis status groups, and varying severity groups of sepsis.
  • Optimal cut-off values for serum NGAL concentrations for diagnosing sepsis and predicting survival were determined using receiver operating characteristic (ROC) curves.
  • The researchers also compared NGAL with two other measures – creatinine and SAA.

Research Findings

  • Median serum NGAL concentrations were significantly higher in septic foals than in non-septic ones.
  • There were no significant differences in NGAL levels among sepsis severity groups.
  • Foals that survived had significantly lower concentrations of NGAL in their serum as compared to those that did not survive.
  • The optimal cut-off values for serum NGAL concentrations were identified as 455 μg/L for diagnosing sepsis (with a sensitivity of 71.4% and specificity of 100%) and 1104 μg/L for predicting non-survival (with a sensitivity of 39.3% and specificity of 95.2%).
  • Analysis showed NGAL was correlated with SAA, but not with creatinine.
  • The performance of NGAL for diagnosing sepsis was found similar to that of SAA.

Conclusion

The research concludes that serum NGAL concentrations can potentially be valuable in diagnosing sepsis in neonatal foals and predicting their survival outcomes.

Cite This Article

APA
Laurberg M, Saegerman C, Jacobsen S, Berg LC, Laursen SH, Hoeberg E, Sånge EA, van Galen G. (2023). Use of admission serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations as a marker of sepsis and outcome in neonatal foals. PLoS One, 18(5), e0285819. https://doi.org/10.1371/journal.pone.0285819

Publication

ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 18
Issue: 5
Pages: e0285819

Researcher Affiliations

Laurberg, Malene
  • Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia.
Saegerman, Claude
  • Medicine and Surgery, Department of Veterinary Clinical Sciences, University of Copenhagen, Taastrup, Denmark.
Jacobsen, Stine
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
Berg, Lise C
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
Laursen, Sigrid Hyldahl
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
Hoeberg, Emma
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
Sånge, Elaine Alexandra
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.
van Galen, Gaby
  • Sydney School of Veterinary Science, University of Sydney, Camden, NSW, Australia.
  • Faculty of Veterinary Medicine, Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR-ULiège), Fundamental and Applied Research for Animal and Health (FARAH) Center, University of Liege, Liege, Belgium.

MeSH Terms

  • Animals
  • Horses
  • Lipocalin-2
  • Creatinine
  • Biomarkers
  • Prospective Studies
  • Sepsis / diagnosis
  • Sepsis / veterinary

Conflict of Interest Statement

The authors have declared that no competing interests exist.

References

This article includes 27 references
  1. Giguère S, Weber EJ, Sanchez LC. Factors associated with outcome and gradual improvement in survival over time in 1065 equine neonates admitted to an intensive care unit.. Equine Vet J 2017 Jan 1;49(1):45–50.
    doi: 10.1111/evj.12536pubmed: 26538009google scholar: lookup
  2. 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 1;33(5):2286–93.
    pmc: PMC6766486pubmed: 31489708
  3. Brewer BD, Koterba AM. Development of a scoring system for the early diagnosis of equine neonatal sepsis.. Equine Vet J 1988;20(1):18–22.
  4. Dembek K, Hurcombe S, Frazer M. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling.. .
    pmc: PMC4189956pubmed: 25295600
  5. Corley KTT, Furr MO. Evaluation of a score designed to predict sepsis in foals.. Journal of Veterinary Emergency and Critical Care 2003;13(3):149–55.
  6. Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG. 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 May 1;32(3):1185–93.
    doi: 10.1111/jvim.15087pmc: PMC5980351pubmed: 29582480google scholar: lookup
  7. Wang M, Zhang Q, Zhao X, Dong G, Li C. Diagnostic and prognostic value of neutrophil gelatinase-associated lipocalin, matrix metalloproteinase-9, and tissue inhibitor of matrix metalloproteinases-1 for sepsis in the Emergency Department: An observational study.. Crit Care 2014 Nov 19;18(6).
    doi: 10.1186/s13054-014-0634-6pmc: PMC4258267pubmed: 25407832google scholar: lookup
  8. Jacobsen S, Berg LC, Tvermose E, Laurberg MB, van Galen G. Validation of an ELISA for detection of neutrophil gelatinase-associated lipocalin (NGAL) in equine serum.. Vet Clin Pathol 2018 Dec 1;47(4):603–7.
    doi: 10.1111/vcp.12670pubmed: 30403420google scholar: lookup
  9. van Galen G, Jacobsen S, Vinther AM, Breinholt Laurberg M, Tvermose E, Broe—Brøndum R, Prior Theisen L, Berg L. NGAL: a new biomarker in the horse for renal injury and inflammation.. 11th Annual European College of Equine Internal Medicine Congress 2019;33:1547–1560.
  10. Frydendal C, Nielsen K. Influence of clinical and experimental intra‐articular inflammation on neutrophil gelatinase‐associated lipocalin concentrations in horses.. Wiley Online Library 2021 Apr 1;50(3):641–9.
    doi: 10.1111/vsu.13582pmc: PMC8048826pubmed: 33522003google scholar: lookup
  11. Winther MF, Haugaard SL, Pihl TH, Jacobsen S. Concentrations of neutrophil gelatinase-associated lipocalin are increased in serum and peritoneal fluid from horses with inflammatory abdominal disease and non-strangulating intestinal infarctions.. Equine Vet J 2022.
    doi: 10.1111/evj.13603doi: 10.1111/evj.13603pubmed: 35642326google scholar: lookup
  12. Bohlin A, Saegerman C, Hoeberg E, Sånge A, Nostell K, Durie I. Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission.. J Vet Intern Med 2019;33(3):1507–13.
    doi: 10.1111/jvim.15487pmc: PMC6524090pubmed: 31004404google scholar: lookup
  13. Wong D. Defining the systemic inflammatory response syndrome in equine neonates.. vetequine.theclinics.com .
    pubmed: 26612743
  14. Singer M, Deutschman C, Jama CS. The third international consensus definitions for sepsis and septic shock (Sepsis-3).. jamanetwork.com .
  15. Petrie A, Watson P. Statistics for veterinary and animal science.. 2013.
  16. Hoeberg E, Sånge A, Saegerman C, Bohlin A, Nostell K, Durie I. Serum amyloid A as a marker to detect sepsis and predict outcome in hospitalized neonatal foals.. Wiley Online Library 2022 Nov 1;36(6):2245–53.
    doi: 10.1111/jvim.16550pmc: PMC9708439pubmed: 36239317google scholar: lookup
  17. Carter J, Lamb E. Evaluating new biomarkers for acute kidney injury: putting the horse before the cart.. American Journal of Kidney Diseases 2014;63(4):543–6.
    doi: 10.1053/j.ajkd.2014.01.005pubmed: 24670481google scholar: lookup
  18. Cervellin G, di Somma S. Neutrophil gelatinase-associated lipocalin (NGAL): the clinician’s perspective.. Clin Chem Lab Med 2012;50(9):1489–93.
    doi: 10.1515/cclm-2012-0433pubmed: 23096016google scholar: lookup
  19. Aamer H, El-Ashker M, Nour E. Sepsis-induced acute kidney injury in equine: current knowledge and future perspectives.. Elsevier .
  20. Smertka M, Wroblewska J, Suchojad A, Majcherczyk M, Jadamus-Niebroj D, Owsianka-Podlesny T. Serum and urinary NGAL in septic newborns.. Biomed Res Int 2014;2014.
    doi: 10.1155/2014/717318pmc: PMC3918693pubmed: 24579085google scholar: lookup
  21. Otto GP, Hurtado-Oliveros J, Chung HY, Knoll K, Neumann T, Müller HJ. Plasma neutrophil gelatinase-associated lipocalin is primarily related to inflammation during sepsis: A translational approach.. PLoS One 2015 Apr 20;10(4).
  22. Mårtensson J, Bell M, Xu S, Bottai M. Association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with sepsis and acute kidney dysfunction.. Taylor & Francis 2013;18(4):349–56.
  23. Chang W, Zhu S, Pan C, Xie JF, Liu SQ, Qiu HB. Predictive utilities of neutrophil gelatinase-associated lipocalin (NGAL) in severe sepsis.. Clinica Chimica Acta 2018 Jun 1;481:200–6.
    doi: 10.1016/j.cca.2018.03.020pubmed: 29572184google scholar: lookup
  24. Macdonald SPJ, Bosio E, Neil C, Arendts G, Burrows S, Smart L. Resistin and NGAL are associated with inflammatory response, endothelial activation and clinical outcomes in sepsis.. Inflammation Research 2017 Jul 1;66(7):611–9.
    doi: 10.1007/s00011-017-1043-5pubmed: 28424824google scholar: lookup
  25. Kari JA, Shalaby MA, Sofyani K, Sanad AS, Ossra AF, Halabi RS. Urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum cystatin C measurements for early diagnosis of acute kidney injury in children admitted to PICU.. World Journal of Pediatrics 2018 Apr 1;14(2):134–42.
    doi: 10.1007/s12519-017-0110-xpubmed: 29464581google scholar: lookup
  26. Siwinska N, Zak A, Paslawska U. Evaluation of serum and urine neutrophil gelatinase-associated lipocalin and cystatin C as biomarkers of acute kidney injury in horses.. J Vet Res 2021 May 16;65(2):245.
    doi: 10.2478/jvetres-2021-0025pmc: PMC8256477pubmed: 34250311google scholar: lookup
  27. Barr B, Nieman NM. Serum amyloid A as an aid in diagnosing sepsis in equine neonates.. Equine Vet J 2022 Sep 1;54(5):922–6.
    doi: 10.1111/evj.13540pubmed: 34773677google scholar: lookup