Determining optimal therapy of dogs with chronic enteropathy by measurement of serum citrulline

Abstract

BackgroundSerum concentration of citrulline is a useful biomarker in human intestinal disease and indicates globally reduced enterocyte mass and absorptive function in various disease states.ObjectivesTo determine whether serum citrulline concentration is a biomarker in chronic enteropathy (CE) in dogs, to provide useful information regarding optimal treatment or to predict outcome.AnimalsSeventy‐four dogs with CE and 83 breed‐ and age‐matched hospital controls with no clinical signs of intestinal disease.MethodsRetrospective study. Outcome was determined and dogs were categorized by response to treatment as having food‐responsive enteropathy (FRE), antibiotic‐responsive diarrhea (ARD), or idiopathic inflammatory bowel disease (IBD). Disease severity was quantified by the CIBDAI scoring index.ResultsSerum citrulline concentration did not differ between dogs with CE (median, 8.4 µg/mL, 5th‐95th percentile 2.0‐19.6) and controls (median, 8.1 µg/mL, 5th‐95th percentile 2.2‐19.7, P = .91). Serum citrulline concentration was similar between dogs with FRE (median, 9.1 µg/mL, 5th‐95th percentile 2.0‐18.9), ARD (median, 13.0 µg/mL, 5th‐95th percentile 1.6‐19.2), IBD (median, 8.4 µg/mL, 5th‐95th percentile 2.1‐21.0; P = .91). Serum citrulline did not correlate to CIBDAI or to serum albumin concentration.Conclusions and Clinical ImportanceIn our study, serum citrulline concentration was not associated with efficacy of treatment or outcome in dogs with CE.

What are the potential biomarkers that should be considered in diagnosing and managing canine chronic inflammatory enteropathies?

“…However, this study failed to show differences in serum citrulline concentrations between dogs with CIE and healthy dogs, as well as among dogs with different forms of CIE (Gerou-Ferriani et al, 2018). Furthermore, researchers observed failure not only in predicting treatment response, but also in correlating citrulline concentrations with disease severity, as determined by CIBDAI (Gerou-Ferriani et al, 2018).…”

“…Citrulline. Citrulline is a non-dietary amino acid produced and released by the enterocytes of the small intestinal mucosa (Xu et al, 2016;Gerou-Ferriani et al, 2018). Citrulline is not available in food; therefore, its serum concentration depends exclusively on the production by small intestine mucosa enterocytes.…”

“…Citrulline is not available in food; therefore, its serum concentration depends exclusively on the production by small intestine mucosa enterocytes. Similarly, a reduced serum concentration corresponds to a reduced enterocyte mass and absorptive function (Gerou-Ferriani et al, 2018). The authors suggested that citrulline has the potential to be an effective biomarker in chronic intestinal diseases in dogs.…”

“…Some breeds have been reported as predisposed for developing CIE, such as Weimaraner, Rottweiler, German Shepherd, Border Collie, Boxer (Dandrieux, 2016), Basenjis, and French bulldogs (Jergens et al, 2009) The observation of clinical signs associated with histopathologic evaluation and systematic therapeutic http://www.openveterinaryjournal.com C. Sacoor et al Open Veterinary Journal, (2020), Vol. 10(4): 412-430 413 trials is currently the gold standard for the diagnosis of CIE (Gerou-Ferriani et al, 2018). Histopathology allows the evaluation of the intestinal inflammatory infiltrate in the lamina propria.…”

“…Hence, to date, the most accurate treatment is one of trial-and-error. Moreover, clinical outcomes for individuals vary widely and are difficult to predict (Gerou-Ferriani et al, 2018). As a result, novel biomarkers have been investigated in efforts to provide a more objective method to assess the natural progression of the disease, help in diagnostic evaluation, assess the temporal changes in clinical activity, patient monitorization, treatment evaluation, response, and outcome prediction (Im Hof et al, 2012;Jergens and Simpson, 2012;Gerou-Ferriani et al, 2018;Otoni et al, 2018).…”