Evaluation of serum amyloid A and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease examined at a tertiary care hospital

Westerman, T.; Tornquist, Susan J.; Foster, Crystal M; Poulsen, Keith P.

doi:10.2460/ajvr.76.10.882

Cited by 22 publications

(27 citation statements)

References 25 publications

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“…The utility of APP as systemic markers of inflammation in horses has been studied by many authors, in response to EED, in mares with experimentally induced ascending placentitis or influenza, or as prognostic indicators for horses with inflammatory disease [17, 39–41]. Jacobsen and Andersen [14] described diseases and disease states accompanied by increased blood levels of SAA in horses.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of uterine lavage and acute phase protein levels as a diagnostic tool for subclinical endometritis in Icelandic mares

et al. 2015

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BackgroundEndometritis is a common problem in a broodmare practice, often leading to infertility. The diagnosis is based on several methods such as cytology, bacteriology and histopathology; however the outcome of these methods may be inconclusive even when used together. The objectives of this study were: (1) to investigate the usefulness of acute phase proteins as an additional diagnostic tool for diagnosis of subclinical endometritis in mares and (2) to evaluate the association between macroscopic changes in uterine flushes and inflammation of the uterus. Materials were collected from 53 Icelandic mares with subclinical endometritis. Endometrial swabs and uterine lavage for cytological and bacteriological examinations and two endometrial biopsies were taken. Blood samples were collected 12–24 h after ovulation to determine the concentrations of serum amyloid A and haptoglobin in the 53 subfertile mares and, for comparison, from 20 non-pregnant mares that later conceived.ResultsTwenty-five mares were classified as positive for endometritis based on endometrial biopsy, which was used as the ‘gold standard’. We observed a correlation between cloudy efflux in the lavage and (1) polymorphonuclear cell (PMN) infiltration of the endometrium (P = 0.031), (2) positive cytology in samples obtained by cotton swabs (P = 0.019) and uterine lavage (P = 0.011), and (3) positive microbiology from samples obtained by cotton swabs (P = 0.001) and uterine lavage (P = 0.047). The degree of agreement between PMN infiltration and positive cytology from samples taken by cotton swabs and uterine lavage was fair to moderate. We found no association between the concentration of acute phase proteins and infiltration of the endometrium by PMNs, or with positive results of cytological and microbiological examinations.ConclusionsMeasurement of serum amyloid A and haptoglobin was not proven useful for diagnosis of subclinical endometritis in Icelandic mares. Macroscopic changes in the fluid collected by lavage were not consistently indicative of infection, but when present they indicate inflammation in the uterus with a high probability.

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Section: Discussionmentioning

confidence: 99%

The usefulness of uterine lavage and acute phase protein levels as a diagnostic tool for subclinical endometritis in Icelandic mares

et al. 2015

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“…Serum/plasma samples (n = 10) were pooled to create a high concentration pool with an average SAA concentration of 2600 μg/mL based on the POC test. The concentration of the high serum pool was selected to remain within the working range of the POC test . Seven dilutions (100, 50, 25, 10, 5, 2.5, and 0%) were made using equine serum with an SAA concentration of 0 μg/mL by the POC test, to span the reported working range of the assay.…”

Section: Methodsmentioning

confidence: 99%

“…Serum amyloid A (SAA) is a major acute phase protein in horses, and its concentration increases rapidly and dramatically in response to inflammatory stimuli [1][2][3][4][5]. SAA in horses has been shown to have clinical utility for diagnosing the presence of inflammation, assessing response to therapy and determining prognosis [1,2,[4][5][6]. Development of SAA testing methodology in veterinary species has been hampered by the absence of species-specific standard material, and equine SAA has not yet been purified [7].…”

Section: Introductionmentioning

confidence: 99%

Analytical validation of a new point‐of‐care assay for serum amyloid A in horses

Schwartz

Pusterla

Jacobsen

et al. 2018

Equine Veterinary Journal

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Summary Background Serum amyloid A (SAA) is a major acute phase protein in horses. A new point‐of‐care (POC) test for SAA (Stablelab) is available, but studies evaluating its analytical accuracy are lacking. Objectives To evaluate the analytical performance of the SAA POC test by 1) determining linearity and precision, 2) comparing results in whole blood with those in serum or plasma, and 3) comparing POC results with those obtained using a previously validated turbidimetric immunoassay (TIA). Study design Assay validation. Methods Analytical validation of the POC test was done in accordance with American Society of Veterinary Clinical Pathology guidelines using residual equine serum/plasma and whole blood samples from the Clinical Pathology Laboratory at the University of California‐Davis. A TIA was used as the reference method. We also evaluated the effect of haematocrit (HCT). Results The POC test was linear for SAA concentrations of up to at least 1000 μg/mL (r = 0.991). Intra‐assay CVs were 13, 18 and 15% at high (782 μg/mL), intermediate (116 μg/mL) and low (64 μg/mL) concentrations. Inter‐assay (inter‐batch) CVs were 45, 14 and 15% at high (1372 μg/mL), intermediate (140 μg/mL) and low (56 μg/mL) concentrations. SAA results in whole blood were significantly lower than those in serum/plasma (P = 0.0002), but were positively correlated (r = 0.908) and not affected by HCT (P = 0.261); proportional negative bias was observed in samples with SAA>500 μg/mL. The difference between methods exceeded the 95% confidence interval of the combined imprecision of both methods (15%). Main limitations Analytical validation could not be performed in whole blood, the sample most likely to be used stall side. Conclusion The POC test has acceptable accuracy and precision in equine serum/plasma with SAA concentrations of up to at least 1000 μg/mL. Low inter‐batch precision at high concentrations may affect serial measurements, and the use of the same test batch and sample type (serum/plasma or whole blood) is recommended. Comparison of results between the POC test and the TIA is not recommended.

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“…A commonly accepted reference interval for SAA concentration in horses is 0 to 20 mg/L, 15 with most reports finding normal horses have SAA values at or lower than 12 mg/L. 6,8,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Several studies have examined the utility of SAA for discriminating between horses with or without inflammation. Animals with systemic inflammation had significantly higher SAA concentrations (mean, 1583 mg/L; range, 688-4000 mg/L) than horses with local or no inflammation (mean of 343 mg/L and range of 37-1609, and mean of 5.6 mg/L and range of 1.8-14.5 mg/L, respectively).…”

Section: Serum Amyloid a In Normal Horses Compared With Horses With Imentioning

confidence: 99%

“…Long & Nolen-Walston serial SAA measurements were obtained, horses with increasing SAA concentrations between 24 and 72 hours of admission were significantly more likely to develop complications or be euthanized, whereas there was no significant difference in outcome in horses with increased SAA concentrations at admission. 25…”

Section: Serum Amyloid a In Normal Horses Compared With Horses With Imentioning

confidence: 99%

Equine Inflammatory Markers in the Twenty-First Century

Long¹,

Nolen-Walston²

2020

Veterinary Clinics of North America: Equine Practice

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Evaluation of serum amyloid A and haptoglobin concentrations as prognostic indicators for horses with inflammatory disease examined at a tertiary care hospital

Abstract: Concentrations of SAA and haptoglobin at admission were not significantly correlated with outcome in horses with inflammatory conditions. Acute-phase proteins likely have more utility in serial analysis rather than testing at a single time point for horses with inflammatory conditions.

Cited by 22 publications

References 25 publications

The usefulness of uterine lavage and acute phase protein levels as a diagnostic tool for subclinical endometritis in Icelandic mares

The usefulness of uterine lavage and acute phase protein levels as a diagnostic tool for subclinical endometritis in Icelandic mares

Analytical validation of a new point‐of‐care assay for serum amyloid A in horses

Equine Inflammatory Markers in the Twenty-First Century

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