Clinical and immunologic assessment of sepsis and the systemic inflammatory response syndrome in cats

Background: Identifying biomarkers to aide in the diagnosis and prognostication of sepsis in dogs would be valuable to veterinarians.Objective: To compare plasma inflammatory mediator concentrations among dogs with sepsis, noninfectious systemic inflammatory response syndrome (NSIRS), and healthy dogs.Animals: Dogs with sepsis (n = 22), NSIRS (n = 23), and healthy dogs (n = 13) presenting to the intensive care unit (ICU) at a veterinary teaching hospital.Methods: Prospective observational study. Clinical parameters were recorded for each dog and plasma tumor necrosis factor (TNF) bioactivity and concentrations of interleukin (IL)-6, CXC chemokine ligand (CXCL)-8 and IL-10 were determined at ICU presentation.Results: Dogs with sepsis and NSIRS were significantly more likely to have measurable TNF activity (sepsis 20/22; NSIRS 19/20; healthy 0/13) and IL-6 concentration (sepsis 12/22; NSIRS 15/23; healthy 2/13), than healthy dogs. Healthy dogs (9/13) were significantly more likely to have measurable plasma IL-10 concentrations than dogs with sepsis (4/19), but not NSIRS (7/20). None of the inflammatory mediators evaluated had optimal sensitivity or specificity for the diagnosis of sepsis. Twelve of 22 dogs with sepsis and 15/23 dogs with NSIRS survived to discharge; none of the measured biomarkers correlated with survival to discharge.Conclusions and Clinical Importance: Sepsis and NSIRS are associated with increased production of the proinflammatory cytokines TNF and IL-6. In addition, sepsis is associated with decreased production of the anti-inflammatory cytokine IL-10. Despite this, plasma TNF, IL-6, CXCL-8, and IL-10 measured at ICU presentation do not appear to be valuable biomarkers to differentiate sepsis from NSIRS, or predict hospital outcome.

Section: Discussioncontrasting

confidence: 99%

Plasma Inflammatory Mediator Concentrations at ICU Admission in Dogs with Naturally Developing Sepsis

DeClue

Sharp

Harmon

2012

“…Criteria of SIRS have not been well established in cats, with different inclusion criteria reported . For the purpose of our study, diagnosis of SIRS was made according to the criteria recently used in cats . However, to increase the specificity of SIRS criteria, we chose the presence of ≥3 criteria, instead of ≥2, as suggested by a previous study of cats .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of systemic inflammatory response syndrome and serum concentrations of acute phase proteins, cholesterol, and total thyroxine in cats with panleukopenia

Petini

Drigo

Zoia

2020

Background Feline parvovirus (FPV) is a common and potentially lethal infectious agent in cats. Objective To assess the prognostic value of age, neuter status, serum concentrations of serum amyloid A (SAA), haptoglobin, cholesterol and total thyroxine (tT4), and the presence of systemic inflammatory response syndrome (SIRS) in cats with panleukopenia. Animals Client‐owned cats with FPV infection diagnosed by a positive fecal ELISA test, positive PCR on feces or blood or both. Methods Retrospective cohort study. The electronic medical database was searched for cats with FPV infection presented between January 2010 and January 2018. Cats were divided into survivors and nonsurvivors according to their survival status 28 days after hospital admission. The prognostic importance of each variable was investigated univariately and by multivariable Cox's proportional‐hazards regression. Finally, receiver operator characteristic (ROC) curve analysis was used to identify the best cutoff value for discriminating survivors from nonsurvivors for the statistically significant prognostic predictors identified by multivariable analysis. Results Seventy cats were enrolled in the study. Multivariable analysis determined that only serum tT4 concentration at hospital admission was significantly (P = .01) associated with survival. A cutoff value of 0.82 μg/dL was identified by ROC curve analysis for serum tT4 concentration in discriminating survivors from nonsurvivors. Sensitivity at this cutoff was 73.9% and specificity was 82.9% (area under the curve, 0.783; 95% confidence interval, 0.668‐0.873; P < .0001). Conclusion and Clinical Relevance Serum tT4 concentration at hospital admission has prognostic value in cats with FPV infection.

“…Serum concentrations of TNF‐α correlate with death in certain types of human sepsis . Studies of naturally occurring sepsis in veterinary patients have yielded similar results, although this pattern appears not to be universal: increased serum concentrations of TNF‐α correlate with mortality in canine parvovirus and neonatal septicemia in cattle and horses, but not in septic cats . TNF‐α is predominantly produced by activated macrophages and T cells—but also by mast cells, B cells, NK cells, neutrophils, endothelial cells, myocytes, osteoblasts, and fibroblasts—as a 26 kDa precursor (pro‐TNF) expressed on the plasma membrane; there it is cleaved by TNF‐converting enzyme (TACE/ADAM17) to yield a 17 kDa soluble form, both the soluble and membrane‐bound forms appearing to be active .…”

Section: Immunopathology Of Sepsismentioning

confidence: 99%

“…Although large‐scale veterinary epidemiological studies are uncommon, a substantial proportion of the critically ill veterinary population is estimated to be septic . The case fatality rate associated with sepsis in a variety of veterinary species is reported to approach 50%, emphasizing the need for a greater understanding of the pathophysiology of sepsis to improve therapeutic practices …”

mentioning

confidence: 99%

The Immunopathology of Sepsis: Pathogen Recognition, Systemic Inflammation, the Compensatory Anti‐Inflammatory Response, and Regulatory T Cells

Lewis

Chan

Pinheiro

et al. 2012

Sepsis, the systemic inflammatory response to infection, represents the major cause of death in critically ill veterinary patients. Whereas important advances in our understanding of the pathophysiology of this syndrome have been made, much remains to be elucidated. There is general agreement on the key interaction between pathogen‐associated molecular patterns and cells of the innate immune system, and the amplification of the host response generated by pro‐inflammatory cytokines. More recently, the concept of immunoparalysis in sepsis has also been advanced, together with an increasing recognition of the interplay between regulatory T cells and the innate immune response. However, the heterogeneous nature of this syndrome and the difficulty of modeling it in vitro or in vivo has both frustrated the advancement of new therapies and emphasized the continuing importance of patient‐based clinical research in this area of human and veterinary medicine.