FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
PloS one2021; 16(4); e0242635; doi: 10.1371/journal.pone.0242635

Utility of cell-free DNA concentrations and illness severity scores to predict survival in critically ill neonatal foals.

Abstract: Plasma cell-free DNA (cfDNA) levels have been associated with disease and survival status in septic humans and dogs. To date, studies investigating cfDNA levels in association with critical illness in foals are lacking. We hypothesized that cfDNA would be detectable in the plasma of foals, that septic and sick-nonseptic foals would have significantly higher cfDNA levels compared to healthy foals, and that increased cfDNA levels would be associated with non-survival. Animals used include 80 foals of 10 days of age or less admitted to a tertiary referral center between January and July, 2020 were stratified into three categories: healthy (n = 34), sick non-septic (n = 11) and septic (n = 35) based on specific criteria. This was a prospective clinical study. Blood was collected from critically ill foals at admission or born in hospital for cfDNA quantification and blood culture. Previously published sepsis score (SS) and neonatal SIRS score (NSIRS) were also calculated. SS, NSIRS, blood culture status and cfDNA concentrations were evaluated to predict survival. Continuous variables between groups were compared using Kruskal-Wallis ANOVA with Dunn's post hoc test. Comparisons between two groups were assessed using the Mann-Whitney U-test or Spearman rank for correlations. The performance of cfDNA, sepsis score and NSIRS score to predict survival was assessed by receiver operator characteristic (ROC) curve analysis including area under the curve, sensitivity and specificity using cutoffs. Plasma cfDNA was detectable in all foals. No significant differences in cfDNA concentration were detected between healthy foals and septic foals (P = 0.65) or healthy foals and sick non-septic foals (P = 0.88). There was no significant association between cfDNA and culture status, SS, NSIRS or foal survival. SS (AUC 0.85) and NSIRS (AUC 0.83) were superior to cfDNA (AUC 0.64) in predicting survival. Although cfDNA was detectable in foal plasma, it offers negligible utility to diagnose sepsis or predict survival in critical illness in neonates.
Get Full Text
Publication Date: 2021-04-26 PubMed ID: 33901192PubMed Central: PMC8075268DOI: 10.1371/journal.pone.0242635Google 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.
LinkedInCopy
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

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 investigates plasma cell-free DNA (cfDNA) levels in critically ill neonatal foals and its link with sepsis and survival rate. However, it concludes that although cfDNA is detectable in the blood of foals, it does not significantly aid in diagnosing sepsis or predicting survival rates in critically ill newborn horses.

Overview of the Study

  • The study aims to assess the usefulness of plasma cell-free DNA (cfDNA) levels as potential markers of disease and survival in critically ill neonatal foals. The research team hypothesized that cfDNA levels would be higher in septic and sick-nonseptic foals compared to healthy ones, and that raised cfDNA levels would correlate with non-survival.
  • For the experiment, 80 foals aged 10 days or younger and admitted to a tertiary referral center between January and July 2020 were used. The young horses were divided into three categories: healthy, sick non-septic, and septic, based on certain criteria.
  • This was a prospective clinical study where blood samples collected from the foals were analyzed for cfDNA concentration and blood culture. The statistical tools used for comparison included Kruskal-Wallis ANOVA with Dunn’s post hoc test, Mann-Whitney U-test, and Spearman rank.

Primary Outcomes

  • It was found that plasma cfDNA was present in all the foals. However, the levels did not significantly differ between healthy foals and septic foals or sick non-septic foals, contradicting the initial hypothesis.
  • There was no significant link between cfDNA levels and culture status, sepsis score (SS), and neonatal Systemic Inflammatory Response Syndrome score (NSIRS).
  • The analysis further indicated that SS and NSIRS were more accurate than cfDNA in predicting survival, as seen from the receiver operator characteristic (ROC) curve analysis. The ROC score for SS and NSIRS was found to be 0.85 and 0.83 respectively, while it was only 0.64 for cfDNA.

Conclusion

  • The study concludes that although cfDNA can be detected in foal plasma, its utility in diagnosing sepsis or predicting survival in critical illnesses in neonates is negligible. This underlines the discrepancy between the study’s initial hypothesis and the results obtained.

Cite This Article

APA
Colmer SF, Luethy D, Abraham M, Stefanovski D, Hurcombe SD. (2021). Utility of cell-free DNA concentrations and illness severity scores to predict survival in critically ill neonatal foals. PLoS One, 16(4), e0242635. https://doi.org/10.1371/journal.pone.0242635

Publication

PloS one
ISSN: 1932-6203
NlmUniqueID: 101285081
Country: United States
Language: English
Volume: 16
Issue: 4
Pages: e0242635

Researcher Affiliations

Colmer, Sarah Florence
  • Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America.
Luethy, Daniela
  • Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America.
Abraham, Michelle
  • Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America.
Stefanovski, Darko
  • Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America.
Hurcombe, Samuel David
  • Department of Clinical Sciences, The University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Philadelphia, Pennsylvania, United States of America.

MeSH Terms

  • Animals
  • Animals, Newborn / genetics
  • Cell-Free Nucleic Acids / genetics
  • Critical Illness / mortality
  • Horse Diseases / genetics
  • Horse Diseases / mortality
  • Horses / genetics
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Sepsis / genetics
  • Sepsis / mortality
  • Sepsis / veterinary
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Systemic Inflammatory Response Syndrome / genetics
  • Systemic Inflammatory Response Syndrome / mortality
  • Systemic Inflammatory Response Syndrome / veterinary

Conflict of Interest Statement

The authors have declared that no competing interests exist.

References

This article includes 54 references
  1. Fielding CL, Magdesian KG. Sepsis and Septic Shock in the Equine Neonate. Vet Clin North Am 2015;31:483–496.
    doi: 10.1016/j.cveq.2015.09.001pubmed: 26612744google scholar: lookup
  2. Paradis MR. Equine Practice. Vet Clin North Am Equine Pract 1994;10:109–135.
    doi: 10.1016/s0749-0739(17)30371-1pubmed: 8039028google scholar: lookup
  3. Giguere 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;49:45–50.
    doi: 10.1111/evj.12536pubmed: 26538009google scholar: lookup
  4. Hurcombe SD, Toribio RE, Slovis N. Blood arginine vasopressin, adrenocorticotropin hormone and cortisol concentrations at admission in septic and critically ill foals and their association with survival. J Vet Intern Med 2008;22:639–647.
    doi: 10.1111/j.1939-1676.2008.0090.xpubmed: 18466247google scholar: lookup
  5. Hurcombe SD, Toribio RE, Slovis NM. Calcium regulating hormones and serum calcium and magnesium concentrations in septic and critically ill foals and their association with survival. J Vet Intern Med 2009;23:335–343.
    doi: 10.1111/j.1939-1676.2009.0275.xpubmed: 19210311google scholar: lookup
  6. Weinbren MJ, Collins M, Heathcote R, Umar M, Nisar M, Ainger C. Optimization of the Blood Culture Pathway: A Template for Improved Sepsis Management and Diagnostic Antimicrobial Stewardship. J Hosp Infect 2018;98:232–235.
    doi: 10.1016/j.jhin.2017.12.023pubmed: 29309813google scholar: lookup
  7. Pusterla N, Mapes S, Burne BA, Magdesian KG. Detection of blood stream infection in neonatal foals with suspected sepsis using real-time PCR. Vet Rec 2009;165:114–117.
    doi: 10.1136/vetrec.165.4.114pubmed: 19633325google scholar: lookup
  8. Hackett ES, Lunn DP, Ferris RA, Horohov DW, Lappin MR, McCue PM. Detection of bacteremia and host response in healthy neonatal foals. Equine Vet J 2015;47:405–409.
    doi: 10.1111/evj.12307pubmed: 24917427google scholar: lookup
  9. Corley KT, Furr MO. Evaluations of a score designed to predict sepsis in foals. J Vet Emerg Crit Care 2003;13:149–155.
  10. Letendre JA, Goggs R. Determining prognosis in canine sepsis by bedside measurement of cell- free DNA and nucleosomes. J Vet Emerg Crit Care 2018;28:503–511.
    doi: 10.1111/vec.12773pubmed: 30299568google scholar: lookup
  11. Avriel A, Wiessman MP, Almog Y, Perl Y, Novack V, Galante O. Admission Cell Free DNA Levels Predict 28-day Mortality in Patients with Severe Sepsis in Intensive Care. PLoS ONE 2014;9:e100514 1–7.
    doi: 10.1371/journal.pone.0100514pmc: PMC4067333pubmed: 24955978google scholar: lookup
  12. Rhodes A, Wort SJ, Thomas H, Wort SJ, Thomas H, Collinson P. Plasma DNA concentration as a predictor of mortality and sepsis in critically ill patients. Crit Care 2006;10:R60.
    doi: 10.1186/cc4894pmc: PMC1550922pubmed: 16613611google scholar: lookup
  13. Yipp BG, Kubes P. NETosis: how vital is it?. Blood 2013;122:2784–2794.
    doi: 10.1182/blood-2013-04-457671pubmed: 24009232google scholar: lookup
  14. Streleckiene G, Forster M, Inciuraite R, Lukosevicius R, Skieceviciene J. Effects of Quantification Methods, Isolation Kits, Plasma Biobanking, and Hemolysis on Cell-Free DNA Analysis in Plasma. Biopreserv Biobank 2019;17:.
    doi: 10.1089/bio.2019.0026pubmed: 31343271google scholar: lookup
  15. Dragan AI, Casas-Finet JR, Bishop ES, Strouse RJ, Schenerman MA, Geddes CD. Characterization of PicoGreen Interaction with dsDNA and the Origin of Its Fluorescence Enhancement Upon Binding. Biophys J 2010;99:3010–3019.
    doi: 10.1016/j.bpj.2010.09.012pmc: PMC2965993pubmed: 21044599google scholar: lookup
  16. Li X, Yuhua Wu, Zhang Li, Cao Y, Li Y, Li J. Comparison of three common DNA concentration measurement methods. Anal Biochem 2014;451:18–24.
    doi: 10.1016/j.ab.2014.01.016pubmed: 24495734google scholar: lookup
  17. Rhodes A, Cecconi M. Cell-free DNA and outcomes in sepsis. Crit Care 2012;16:170.
    doi: 10.1186/cc11508pmc: PMC3672553pubmed: 23140420google scholar: lookup
  18. Saukkonen K, Lakkisto P, Pettila V, Varpula M, Karlsson S, Ruokonen E. Cell-free plasma DNA as a predictor of outcome in severe sepsis and septic shock. Clin Chem 2008;45:1000–1007.
    doi: 10.1373/clinchem.2007.101030pubmed: 18420731google scholar: lookup
  19. Letendre KA, Goggs R. Measurement of plasma cell-free DNA concentrations in dogs with sepsis, trauma and neoplasia. J Vet Emerg Crit Care 2017;3:307–314.
    doi: 10.1111/vec.12592pubmed: 28295988google scholar: lookup
  20. Wong DM, Ruby RE, Dembek KA, Barr BS, Ruess 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;32:1185–1193.
    doi: 10.1111/jvim.15087pmc: PMC5980351pubmed: 29582480google scholar: lookup
  21. Dembek KA, Onasch K, Hurcombe SDA, MacGillivray KC, Slovis NM, Barr BS. Renin-Angiotensin-Aldosterone system and hypothalamic-pituitary-adrenal axis in hospitalized neonatal foals. J Vet Intern Med 2013;27:331–338.
    doi: 10.1111/jvim.12043pubmed: 23398197google scholar: lookup
  22. Barnsick RJIM, Hurcombe SDA, Dembek KA, Frazer ML, Slovis NM, Saville WJA. Somatotropic axis resistance and ghrelin in critically ill foals. Equine Vet J 2014;46:45–49.
    doi: 10.1111/evj.12086pubmed: 23663031google scholar: lookup
  23. Sato A, Nakashhima C, Abe T, Kato J, Hirai M, Nakamura T. Investigation of appropriate pre-analytical procedure for circulating free DNA from liquid biopsy. Oncotarget 2018;9:31904–31914.
    doi: 10.18632/oncotarget.25881pmc: PMC6112748pubmed: 30159131google scholar: lookup
  24. Hollis A, Wilkins P, Palmer J, Boston RC. Bacteremia in equine neonatal diarrhea: a retrospective study (1990–2007). J Vet Intern Med 2008;22:1203–1209.
    doi: 10.1111/j.1939-1676.2008.0152.xpubmed: 18638014google scholar: lookup
  25. Forsblom E, Aittoniemi J, Ruostalainen E. High cell-free DNA predicts fatal outcome among Staphylococcus aureus bacteraemia patients with intensive care unit treatment. PLoS One 2014;9(2):e87741.
    doi: 10.1371/journal.pone.0087741pmc: PMC3919733pubmed: 24520336google scholar: lookup
  26. Huttunen R, Kuparinen T, Jylhava J. Fatal outcome in bacteremia is characterized by high plasma cell free DNA concentration and apoptotic DNA fragmentation: a prospective cohort study. PLoS One 2011;6(7):e21700.
    doi: 10.1371/journal.pone.0021700pmc: PMC3128600pubmed: 21747948google scholar: lookup
  27. Tagawa M, Shimbo G, Inokuma H, Miyahara K. Quantification of plasma cell-free DNA levels in dogs with various tumors. J Vet Diagn Invest 2019;31(6):836–843.
    doi: 10.1177/1040638719880245pmc: PMC6900719pubmed: 31585514google scholar: lookup
  28. Jeffery U, Kimura K, Gray R, Lueth P, Bellaire B, LeVine D. Dogs cast NETs too: Canine neutrophil extracellular traps in health and immune‐mediated hemolytic anemia. Vet Immunol Immunopathol 2015;168:262–268.
    doi: 10.1016/j.vetimm.2015.10.014pubmed: 26574161google scholar: lookup
  29. Rushton JG, Ertl R, Klein D, Tichy A, Nell B. Circulating cell-free DNA does not harbour a diagnostic benefit in cats with feline diffuse iris melanomas. J Feline Med Surg 2019;21(2):124–132.
    doi: 10.1177/1098612X18762017pmc: PMC10814613pubmed: 29529957google scholar: lookup
  30. Huang T, Yang Z, Chen S, Chen J. Predictive value of plasma cell-free DNA for prognosis of sepsis. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018;30(10):925–928.
    doi: 10.3760/cma.j.issn.2095-4352.2018.010.003pubmed: 30439309google scholar: lookup
  31. Tuaeva NO, Abramova ZI, Softonov VV. The Origin of Elevated Levels of Circulating DNA in Blood Plasma of Premature Neonates. Ann N Y Acad Sci 2008;1137:27–30.
    doi: 10.1196/annals.1448.043pubmed: 18837920google scholar: lookup
  32. Perkins GA, Wagner B. The development of equine immunity: Current knowledge on immunity in the young horse. Eq Vet J 2014;47:267–274.
    pubmed: 25405920
  33. Aucamp J, Bronkhorst AJ, Badenhorst CPS, Pretorius PJ. The diverse origins of circulating cell-free DNA in the human body: a critical re-evaluation of the literature. Biol Rev Camb Philos Soc 2018;93:1649–1683.
    doi: 10.1111/brv.12413pubmed: 29654714google scholar: lookup
  34. Goggs R, Jeffery U, LeVine DN, Li RHL. Neutrophil-Extracellular Traps, Cell-Free DNA, and Immunothrombosis in Companion Animals: A Review. Vet Pathol 2020;57(1):6–23.
    doi: 10.1177/0300985819861721pubmed: 31342866google scholar: lookup
  35. Li HL, Ng G, Tablin F. Lipopolysaccharide-induced neutrophil extracellular trap formation in canine neutrophils is dependent on histone H3 citrullination by peptidylarginine deiminase. Vet Immunol Immunopathol 2017;193–194:29–37.
    doi: 10.1016/j.vetimm.2017.10.002pubmed: 29129225google scholar: lookup
  36. McTaggart A, Yovich JV, Penhale J, Raidal SL. A comparison of foal and adult horse neutrophil function using flow cytometric techniques. Res Vet Sci 2001;71(1):73–79.
    doi: 10.1053/rvsc.2001.0490pubmed: 11666151google scholar: lookup
  37. Feary DJ, Hassel DM. Enteritis and Colitis in Horses. Vet Clin Equine 2006;22:437–479.
    doi: 10.1016/j.cveq.2006.03.008pubmed: 16882483google scholar: lookup
  38. Carr EA, Carlson GP, Wilson WD, Read DH. Acute hemorrhagic pulmonary infarction and necrotizing pneumonia in horses: 21 cases (1967–1993). J Am Vet Med Assoc 1997;12:1774–1778.
    pubmed: 9187729
  39. Khetan D, Gupta N, Chaudhary R. Comparison of UV spectrometry and fluorometry-based methods for quantification of cell-free DNA in red cell components. Asian J Transfus Sci 2019;13:95–99.
    doi: 10.4103/ajts.AJTS_90_19pmc: PMC6910032pubmed: 31896914google scholar: lookup
  40. Goldstein H, Hausmann MJ, Douvdenani A. A rapid direct fluorescent assay for cell-free DNA quantification in biological fluids. Clin Biochem 2009;46:488–494.
    pubmed: 19729503
  41. Xue X, Teare MD, Holen I, Zhu YM, Woll PJ. Optimizing the yield and utility of circulating cell-free DNA from plasma and serum. Clin Chim Acta 2009;404:100–104.
    doi: 10.1016/j.cca.2009.02.018pubmed: 19281804google scholar: lookup
  42. Jung K, Fleischhacker M, Rabien A. Cell-free DNA in the blood as a solid tumor biomarker–a critical appraisal of the literature. Clin Chim Acta 2010;411:1611–1624.
    doi: 10.1016/j.cca.2010.07.032pubmed: 20688053google scholar: lookup
  43. Schaefer DMW, Forman MA, Kisseberth WC, Lehman AM, Kelbick NT, Harper P, Rush LJ. Quantification of plasma DNA as a prognostic indicator in canine lymphoid neoplasma. Vet Comp Oncol 2007;5:145–155.
    doi: 10.1111/j.1476-5829.2007.00122.xpubmed: 19754786google scholar: lookup
  44. Burnett DL, Cave NJ, Gedye KR, Bridges JP. Investigation of cell-free DNA in canine plasma and its relation to disease. Vetinary Quarterly 2016;36:122–129.
    doi: 10.1080/01652176.2016.1182230pubmed: 27103480google scholar: lookup
  45. Borchers A, Wilkins PA, Marsh PM, Axon JE, Read J, Castagnetti C, er al. Association on admission L-lactate concentration in hospitalized equine neonates and with presenting complaint, periparturient events, clinical diagnosis and outcome: a prospective multicenter study. Equine Vet J 2012;44(41):57–63.
    pubmed: 22594028
  46. Furr M, McKenzie H. Factors associated with the risk of positive blood culture in neonatal foals presented to a referral center (2000–2014). J Vet Intern Med 2020;1–13.
    doi: 10.1111/jvim.15923pmc: PMC7694804pubmed: 33044020google scholar: lookup
  47. Norberg A, Christopher NC, Ramundo ML, Bower JR, Berman SA. Contamination rates of blood cultures obtained by dedicated phlebotomy vs intravenous catheter. JAMA 2003;289:726–729.
    doi: 10.1001/jama.289.6.726pubmed: 12585951google scholar: lookup
  48. Weinbaum FL, Lavie S, Danek M, Sixsmith D, Heinrich GF, Mills SS. Doing it right the first time: quality improvement and the contaminant blood culture. J Clin Microbiol 1997;35:563–565.
    doi: 10.1128/JCM.35.3.563-565.1997pmc: PMC229627pubmed: 9041389google scholar: lookup
  49. Hall KK, Lyman JA. Updated Review of Blood Culture Contamination. Clin Microbiol Rev 2006;19:788–802.
    doi: 10.1128/CMR.00062-05pmc: PMC1592696pubmed: 17041144google scholar: lookup
  50. Bates DW, Goldman L, Lee TH. Contaminant blood cultures and resource utilization: the true consequences of false-positive results. JAMA 1991;265:365–369.
    pubmed: 1984535
  51. Dunagan WC, Woodward RS, Medoff G, Gray III JL, Casabr E, Smith MD. Antimicrobial misuse in patients with positive blood cultures. Am J Med 1989;87:253–259.
    doi: 10.1016/s0002-9343(89)80146-9pubmed: 2773963google scholar: lookup
  52. Scheer CS, Fuchs C, Grundling M, Vollmer M, Bast J, Bohnert JA. Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study. Clin Micribiol Infect 2019;25:326–331.
    doi: 10.1016/j.cmi.2018.05.016pubmed: 29879482google scholar: lookup
  53. Weiss SL, Fitzgerald JC, Balamuth F, Alpern ER, Lavelle J, Chilutti M. Delayed antimicrobial therapy increases mortality and organ dysfunction in pediatric sepsis. Crit Care Med 2014;42:2409–2417.
    doi: 10.1097/CCM.0000000000000509pmc: PMC4213742pubmed: 25148597google scholar: lookup
  54. Wisdom A, Eaton V, Gordon D, Daniel S, Woodman R, Phillips C. INITAIT-E.D.: impact of timing of INITIation of Antibiotic Therapy on mortality of patients presenting to an Emergency Department with sepsis. Emerg Med Australas 2015;27:196–201.
    doi: 10.1111/1742-6723.12394pubmed: 25847048google scholar: lookup

Citations

This article has been cited 7 times.
  1. Chen LT, Wesdorp E, Jager M, Siegers EW, Theelen MJP, Besselink N, Vermeulen C, Zomer AL, Broens EM, Wagenaar JA, de Ridder J. Bacterial cell-free DNA profiling reveals the co-elevation of multiple bacteria in newborn foals with suspected sepsis. iScience 2025 Dec 19;28(12):114005.
    doi: 10.1016/j.isci.2025.114005pubmed: 41476946google scholar: lookup
  2. Bayless RL, Cooper BL, Sheats MK. Extracted Plasma Cell-Free DNA Concentrations Are Elevated in Colic Patients with Systemic Inflammation. Vet Sci 2024 Sep 12;11(9).
    doi: 10.3390/vetsci11090427pubmed: 39330806google scholar: lookup
  3. Hobbs KJ, Cooper BL, Dembek K, Sheats MK. Investigation of Extracted Plasma Cell-Free DNA as a Biomarker in Foals with Sepsis. Vet Sci 2024 Aug 1;11(8).
    doi: 10.3390/vetsci11080346pubmed: 39195800google scholar: lookup
  4. Ferchiou S, Caza F, de Boissel PGJ, Villemur R, St-Pierre Y. Applying the concept of liquid biopsy to monitor the microbial biodiversity of marine coastal ecosystems. ISME Commun 2022 Jul 27;2(1):61.
    doi: 10.1038/s43705-022-00145-0pubmed: 37938655google scholar: lookup
  5. Birckhead EM, Das S, Tidd N, Raidal SL, Raidal SR. Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy. J Vet Diagn Invest 2023 Nov;35(6):751-760.
    doi: 10.1177/10406387231196552pubmed: 37661696google scholar: lookup
  6. Panizzi L, Dittmer KE, Vignes M, Doucet JS, Gedye K, Waterland MR, Rogers CW, Sano H, McIlwraith CW, Riley CB. Plasma and Synovial Fluid Cell-Free DNA Concentrations Following Induction of Osteoarthritis in Horses. Animals (Basel) 2023 Mar 14;13(6).
    doi: 10.3390/ani13061053pubmed: 36978592google scholar: lookup
  7. Bayless RL, Cooper BL, Sheats MK. Investigation of plasma cell-free DNA as a potential biomarker in horses. J Vet Diagn Invest 2022 May;34(3):402-406.
    doi: 10.1177/10406387221078047pubmed: 35168428google scholar: lookup
Subscribe to our newsletter
Join 99,780 horse owners like you who receive our email updates on horse health and nutrition.