Assessment of systemic inflammation by time‐trends of blood granulocyte count and plasma myeloperoxidase and elastase concentrations following colic surgery in horses

Salciccia, Alexandra; Grulke, Sigrid; Pouyade, Geoffroy de la Rebière de; Franck, Thierry; Detilleux, Johann; Serteyn, Didier; Sandersen, Charlotte

doi:10.1111/vec.12481

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“…Using enzymes that mainly stem from neutrophils and are markers of neutrophil stimulation and degranulation for the detection of synovial sepsis offers the advantage of being based on the first line immune response to infection and measuring neutrophil activity rather than just cellular presence [40,[61][62][63]. In non-infectious states, MPO plasma concentrations correlate with the total number of neutrophils in the blood, while LYS concentrations correlate with their turnover rate [62][63][64]. The small molecular weight protein LYS may function as a highly responsive biomarker of synovial inflammation and sepsis, as its half-life in plasma is only 75 min [61], and could thus serve as a reliable marker not just for initial diagnosis but also for monitoring of treatment success.…”

Section: Discussionmentioning

confidence: 99%

“… 40 , 61 , 62 , 63 In noninfectious states, MPO plasma concentrations correlate with the total number of neutrophils in the blood, while LYS concentrations correlate with their turnover rate. 62 , 63 , 64 The small molecular weight (14‐15 kDa) protein LYS may function as a highly responsive biomarker of synovial inflammation and sepsis, as its half‐life in plasma is only 75 min, 61 and could, thus, serve as a reliable marker not just for initial diagnosis but also for monitoring of treatment success.…”

Section: Discussionmentioning

confidence: 99%

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Detection of synovial sepsis in horses using enzymes as biomarkers

Haralambus

Florczyk

Sigl

et al. 2021

Equine Veterinary Journal

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Background: Synovial sepsis is a commonly occurring, potentially career-ending or even lifethreatening orthopaedic emergency. Diagnosis of synovial sepsis is currently primarily based on synovial fluid analysis, which often leaves diagnostic ambiguity due to overlap of clinicopathologic parameters between septic and aseptic inflammatory synovitis. Objectives:To evaluate the reliability of lysozyme (LYS), myeloperoxidase (MPO) and elastase (ELT) as biomarkers for synovial sepsis in horses using a photometric assay to measure increased enzyme activity.Study design: Prospective, single-blinded, analytical, clinical study.Methods: Equine synovial samples were assigned to one of three groups: 1) healthy controls (n=10); 2) aseptic (n=27) and 3) septic synovitis (n=30). The enzyme activity assays (LYS, MPO, ELT) were compared with standard synovial fluid parameters and broad-range bacterial 16S rDNA PCR.Results: LYS and MPO activities were significantly different between septic synovial samples, and both aseptic and control samples (p<0.001, LYS: confidence interval [CI]: 2.25-3.41 resp. 2.21-3.8, MPO: CI 0.752-1.6 resp. 0.639-1.81). LYS achieved a 100% sensitivity and 100% specificity in differentiating between septic and aseptic (cut-off value 751.4) or control (cut-off: 484.6) samples (p<0.001). MPO reached 93.33% sensitivity, 100% specificity for distinguishing septic from control (cut-off value: 0.1254) synovial samples and 93.33% sensitivity, 81.48% specificity for discriminating between septic and aseptic (cut-off value: 0.1305) synovial samples (p<0.001).ELT activity could not be measured in any synovial sample. Both the LYS and the MPO measurements showed a highly significant correlation with PCR (LYS r= 0.79, MPO r = 0.69), synovial leukocyte count (LYS r= 0.752, MPO r = 0.571), % neutrophils (LYS r=0.751, MPO r = 0.663) and each other (r=0.744, all p<0.001).Main limitations: Variation in horses' signalment, affected synovial structures, and synovial fluid freezing times may have affected the discriminative power of this study. Conclusions:Increased MPO and LYS activities allow reliable, rapid diagnosis of synovial sepsis with high sensitivity and specificity.

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