Utility of C-reactive protein and serum amyloid A in the diagnosis of equine protozoal myeloencephalitis.
Abstract: Accurate antemortem EPM diagnosis requires evidence of intrathecal antibody production. Some advocate the use of acute phase proteins in addition to serology, which alone results in substantial false positives. Objective: The purpose of this study was to determine if serum C-reactive protein (CRP) or serum amyloid A (SAA) concentrations were elevated in cases of equine protozoal myeloencephalitis (EPM) compared to other neurological diseases. Methods: 25 clinical cases of equine neurological disease: EPM (10), cervical vertebral stenotic myelopathy (CVSM) (10), neuroborreliosis (2), equine motor neuron disease (1), degenerative myelopathy (1), and leukoencephalomalacia (1). Methods: Serum and CSF CRP and SAA were measured. Selection criteria included neurologic disease, antemortem diagnosis of EPM or CVSM, or postmortem diagnosis of EPM, CVSM, or other neurologic disease, and availability of serological results and archived samples for testing. Results: Serum SAA and serum CRP levels were generally undetectable or low in horses with EPM (median CRP ≤0.1 mg/L, ≤0.1-14.4 mg/L; median SAA ≤0.1 mg/L, ≤0.1-6.11 mg/L) and CVSM (median CRP ≤0.1, ≤0.1-2.41 mg/L; median SAA ≤0.1mg/L, ≤0.1-13.88 mg/L). CSF CRP and SAA for horses with EPM (median CRP 3.35 mg/l, 0.19-13.43 mg/l; median SAA ≤0.1 mg/L, ≤0.1-2.4 mg/L) and CVSM (median CRP 4.015 mg/L, 0.16-9.62 mg/L; median SAA 0.62 mg/L, ≤0.1-2.91 mg/L) were also undetectable or low. Kruskal-Wallis test showed no statistically significant differences between serum CRP (P = .14), serum SAA (P = .79), spinal fluid CRP (P = .65), or spinal fluid SAA between horses with EPM and CVSM (P = .52). Conclusions: Neither SAA nor CRP in serum or CSF aid diagnosis of EPM.
© 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2018-09-14 PubMed ID: 30216559PubMed Central: PMC6189384DOI: 10.1111/jvim.15254Google 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
- Acute Phase Proteins
- Cerebrospinal Fluid
- Clinical Pathology
- Clinical Study
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Equine Diseases
- Equine Health
- Equine Protozoal Myeloencephalitis
- Horses
- In Vivo
- Neurological Diseases
- Neurology
- Post Mortem
- Serology
- Serum Amyloid A
- Veterinary Medicine
- Veterinary Research
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 study aimed to assess whether levels of C-reactive protein (CRP) or serum amyloid A (SAA) were higher in horses with equine protozoal myeloencephalitis (EPM) in comparison to horses with other neurological diseases. The results revealed that CRP and SAA levels were generally low or undetectable in EPM cases and neither of these markers significantly aided the diagnosis of EPM.
Study Objective and Methods
- The goal of the study was to determine whether serum CRP or SAA concentrations could be used to diagnose cases of EPM, a major health issue in horses.
- The current process for EPM diagnosis requires evidence of intrathecal (within a sheath) antibody production and some suggest the inclusion of acute phase proteins along with serology for more accurate results.
- The researchers measured CRP and SAA levels in serum and Cerebrospinal Fluid (CSF) in 25 clinical cases of equine neurological diseases.
- The diseases included EPM, cervical vertebral stenotic myelopathy (CVSM), neuroborreliosis, equine motor neuron disease, degenerative myelopathy, and leukoencephalomalacia.
- Eligibility for selection was based on neurological disease, antemortem diagnosis of EPM or CVSM, or postmortem diagnosis of EPM, CVSM, or other neurological disease, plus the availability of serological results and archived samples for testing.
Study Results
- The researchers found that horses with EPM and CVSM typically have low or undetectable concentrations of SAA and CRP in their serum and CSF.
- The researchers used the non-parametric Kruskal-Wallis test to compare groups and found no statistically significant difference between the levels of either serum or spinal fluid CRP and SAA in horses with EPM and horses with CVSM.
Study Conclusion
- The study concluded that neither SAA nor CRP markers in serum or CSF aid in the diagnosis of EPM.
- Thus, it was determined that these markers would not be beneficial additions to the current diagnostic process for EPM.
Cite This Article
APA
Mittelman NS, Stefanovski D, Johnson AL.
(2018).
Utility of C-reactive protein and serum amyloid A in the diagnosis of equine protozoal myeloencephalitis.
J Vet Intern Med, 32(5), 1726-1730.
https://doi.org/10.1111/jvim.15254 Publication
Researcher Affiliations
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson).
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson).
- From the Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA (Mittelman, Stefanovski, Johnson).
MeSH Terms
- Animals
- Antibodies, Protozoan / blood
- Biomarkers
- C-Reactive Protein / metabolism
- Central Nervous System Protozoal Infections / blood
- Central Nervous System Protozoal Infections / diagnosis
- Central Nervous System Protozoal Infections / veterinary
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horse Diseases / metabolism
- Horses
- Serum Amyloid A Protein / metabolism
References
This article includes 24 references
- Reed SM, Furr M, Howe DK, Johnson AL, MacKay RJ, Morrow JK, Pusterla N, Witonsky S. Equine Protozoal Myeloencephalitis: An Updated Consensus Statement with a Focus on Parasite Biology, Diagnosis, Treatment, and Prevention.. J Vet Intern Med 2016 Mar-Apr;30(2):491-502.
- Reed SM, Howe DK, Morrow JK, Graves A, Yeargan MR, Johnson AL, MacKay RJ, Furr M, Saville WJ, Williams NM. Accurate antemortem diagnosis of equine protozoal myeloencephalitis (EPM) based on detecting intrathecal antibodies against Sarcocystis neurona using the SnSAG2 and SnSAG4/3 ELISAs.. J Vet Intern Med 2013 Sep-Oct;27(5):1193-200.
- Johnson AL, Morrow JK, Sweeney RW. Indirect fluorescent antibody test and surface antigen ELISAs for antemortem diagnosis of equine protozoal myeloencephalitis.. J Vet Intern Med 2013 May-Jun;27(3):596-9.
- Ellison SP, Kennedy TJ, Li A. Neuritogenic peptides derived from equine myelin P2 basic protein detect circulating antibodies in ataxic horses.. Int J Appl Res Vet Med 2015;13:175‐181.
- Young B, Gleeson M, Cripps AW. C-reactive protein: a critical review.. Pathology 1991 Apr;23(2):118-24.
- Bathen-Noethen A, Carlson R, Menzel D, Mischke R, Tipold A. Concentrations of acute-phase proteins in dogs with steroid responsive meningitis-arteritis.. J Vet Intern Med 2008 Sep-Oct;22(5):1149-56.
- Lowrie M, Penderis J, McLaughlin M, Eckersall PD, Anderson TJ. Steroid responsive meningitis-arteritis: a prospective study of potential disease markers, prednisolone treatment, and long-term outcome in 20 dogs (2006-2008).. J Vet Intern Med 2009 Jul-Aug;23(4):862-70.
- Morimatsu M, Sakai H, Yoshimatsu K. Isolation, characterization, and quantitative analysis of C‐reactive protein from horses.. Am J Vet Res 1989;51:723‐1220.
- Jacobsen S, Andersen PH. The acute phase protein serum amyloid A (SAA) as a marker of inflammation in horses.. Equine Vet Educ 2010;19:38‐46.
- Kjelgaard-Hansen M, Jensen AL, Kristensen AT. Evaluation of a commercially available human C-reactive protein (CRP) turbidometric immunoassay for determination of canine serum CRP concentration.. Vet Clin Pathol 2003;32(2):81-7.
- Jacobsen S, Kjelgaard-Hansen M, Hagbard Petersen H, Jensen AL. Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations.. Vet J 2006 Sep;172(2):315-9.
- Belgrave RL, Dickey MM, Arheart KL, Cray C. Assessment of serum amyloid A testing of horses and its clinical application in a specialized equine practice.. J Am Vet Med Assoc 2013 Jul 1;243(1):113-9.
- Nakamura M, Takahashi M, Ohno K, Koshino A, Nakashima K, Setoguchi A, Fujino Y, Tsujimoto H. C-reactive protein concentration in dogs with various diseases.. J Vet Med Sci 2008 Feb;70(2):127-31.
- Hahn CN, Mayhew IG, Whitwell KE, Smith KC, Carey D, Carter SD, Read RA. A possible case of Lyme borreliosis in a horse in the UK.. Equine Vet J 1996 Jan;28(1):84-8.
- Imai DM, Barr BC, Daft B, Bertone JJ, Feng S, Hodzic E, Johnston JM, Olsen KJ, Barthold SW. Lyme neuroborreliosis in 2 horses.. Vet Pathol 2011 Nov;48(6):1151-7.
- Tveitnes D, Øymar K, Natås O. Laboratory data in children with Lyme neuroborreliosis, relation to clinical presentation and duration of symptoms.. Scand J Infect Dis 2009;41(5):355-62.
- Jeppsson B, Freund HR, Gimmon Z, James JH, von Meyenfeldt MF, Fischer JE. Blood-brain barrier derangement in sepsis: cause of septic encephalopathy?. Am J Surg 1981 Jan;141(1):136-42.
- Gahmberg CG, Andersson LC. Leukocyte surface origin of human alpha1-acid glycoprotein (orosomucoid).. J Exp Med 1978 Aug 1;148(2):507-21.
- Anderson KM, Welsh CJ, Young C, Levine GJ, Kerwin SC, Boudreau CE, Reyes I, Mondragon A, Griffin JF 4th, Cohen ND, Levine JM. Acute Phase Proteins in Cerebrospinal Fluid from Dogs with Naturally-Occurring Spinal Cord Injury.. J Neurotrauma 2015 Nov 1;32(21):1658-65.
- Martínez-Subiela S, Caldin M, Parra MD, Ottolini N, Bertolini G, Bernal LJ, García-Martinez JD, Cerón JJ. Canine C-reactive protein measurements in cerebrospinal fluid by a time-resolved immunofluorimetric assay.. J Vet Diagn Invest 2011 Jan;23(1):63-7.
- Magnarelli LA, Ijdo JW, Van Andel AE, Wu C, Padula SJ, Fikrig E. Serologic confirmation of Ehrlichia equi and Borrelia burgdorferi infections in horses from the northeastern United States.. J Am Vet Med Assoc 2000 Oct 1;217(7):1045-50.
- Johnstone LK, Engiles JB, Aceto H, Buechner-Maxwell V, Divers T, Gardner R, Levine R, Scherrer N, Tewari D, Tomlinson J, Johnson AL. Retrospective Evaluation of Horses Diagnosed with Neuroborreliosis on Postmortem Examination: 16 Cases (2004-2015).. J Vet Intern Med 2016 Jul;30(4):1305-12.
- Sen J, Belli A. S100B in neuropathologic states: the CRP of the brain?. J Neurosci Res 2007 May 15;85(7):1373-80.
- Doumatey AP, Zhou J, Adeyemo A, Rotimi C. High sensitivity C-reactive protein (Hs-CRP) remains highly stable in long-term archived human serum.. Clin Biochem 2014 Mar;47(4-5):315-8.
Citations
This article has been cited 3 times.- Arfuso F, Rizzo M, Giannetto C, Giudice E, Piccione G, Fazio F, Cirincione R, Cassata G, Cicero L. Inflammatory-like status and acute stress response in horses after road transport.. Sci Rep 2023 Jun 17;13(1):9858.
- Long A, Nolen-Walston R. Equine Inflammatory Markers in the Twenty-First Century: A Focus on Serum Amyloid A.. Vet Clin North Am Equine Pract 2020 Apr;36(1):147-160.
- Dhama K, Latheef SK, Dadar M, Samad HA, Munjal A, Khandia R, Karthik K, Tiwari R, Yatoo MI, Bhatt P, Chakraborty S, Singh KP, Iqbal HMN, Chaicumpa W, Joshi SK. Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values.. Front Mol Biosci 2019;6:91.
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