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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.
Copyright: © 2023 Laurberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Publication Date: 2023-05-18 PubMed ID: 37200285PubMed Central: PMC10194986DOI: 10.1371/journal.pone.0285819Google Scholar: Lookup
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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

PloS one
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.

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Citations

This article has been cited 3 times.
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  2. Wilkins PA, Wong D, Slovis NM, Collins N, Barr BS, MacKenzie C, De Solis CN, Castagnetti C, Mariella J, Burns T, Perkins G, Delvescovo B, Sanchez LC, Kemper AM, Magdesian KG, Bedenice D, Taylor SD, Gold J, Dunkel B, Pranzo G, Constable PD. The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals. J Vet Intern Med 2025 Mar-Apr;39(2):e70004.
    doi: 10.1111/jvim.70004pubmed: 40091577google scholar: lookup
  3. Ferreira GS, Frota ML, Gonzaga MJD, Vattimo MFF, Lima C. The Role of Biomarkers in Diagnosis of Sepsis and Acute Kidney Injury. Biomedicines 2024 Apr 23;12(5).
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