Endoscopic, Biopsy, and Histopathologic Guidelines for the Evaluation of Gastrointestinal Inflammation in Companion Animals

Washabau, R. J.; Day, M. J.; Willard,; Hall, Edward J; Ae, Jergens; Mansell, Joanne; Minami, T; Bilzer, Thomas

doi:10.1111/j.1939-1676.2009.0443.x

Cited by 313 publications

(298 citation statements)

References 87 publications

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“…Chronic inflammatory enteropathies (CIE) in dogs comprise a group of disorders that are characterized by chronic persistent or recurrent gastrointestinal signs, histologic evidence of mucosal inflammation, and the exclusion of other underlying gastrointestinal or extra‐gastrointestinal diseases 1, 2, 3, 4. Clinicopathologic variables, fecal parasite examination, and diagnostic imaging are important means to rule out other etiologies with a similar clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

Heilmann

Steiner

2018

Veterinary Internal Medicne

108

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Chronic inflammatory enteropathies (CIE) in dogs are a group of disorders that are characterized by chronic persistent or recurrent signs of gastrointestinal disease and histologic evidence of mucosal inflammation. These CIEs are classified as either food‐responsive, antibiotic‐responsive, or immunosuppressant‐responsive enteropathy. Patients not clinically responding to immunomodulatory treatment are grouped as nonresponsive enteropathy and dogs with intestinal protein loss as protein‐losing enteropathy. Disease‐independent clinical scoring systems were established in dogs for assessment of clinical disease severity and patient monitoring during treatment. Histopathologic and routine clinicopathologic findings are usually not able to distinguish the subgroups of CIE. Treatment trials are often lengthy and further diagnostic tests are usually at least minimally invasive. Biomarkers that can aid in defining the presence of disease, site of origin, severity of the disease process, response to treatment, or a combination of these would be clinically useful in dogs with CIE. This article summarizes the following biomarkers that have been evaluated in dogs with CIE during the last decade, and critically evaluates their potential clinical utility in dogs with CIE: functional biomarkers (cobalamin, methylmalonic acid, folate, α1‐proteinase inhibitor, immunoglobulin A), biochemical biomarkers (C‐reactive protein, perinuclear anti‐neutrophilic cytoplasmic antibodies, 3‐bromotyrosine, N‐methylhistamine, calprotectin, S100A12, soluble receptor of advanced glycation end products, cytokines and chemokines, alkaline phosphatase), microbiomic biomarkers (microbiome changes, dysbiosis index), metabolomic biomarkers (serum metabolome), genetic biomarkers (genomic markers, gene expression changes), and cellular biomarkers (regulatory T cells). In addition, important performance criteria of diagnostic tests are briefly reviewed.

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Section: Introductionmentioning

confidence: 99%

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

Heilmann

Steiner

2018

Veterinary Internal Medicne

108

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“…Eosinophils are present in the healthy human and canine intestine in variable number 14, 16, 17. Abnormal accumulation of eosinophils in the intestine in the absence of other underlying causes (eg, parasitic infections) is a characteristic feature of EGID, including IBD 4, 19.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal accumulation of eosinophils in the intestine in the absence of other underlying causes (eg, parasitic infections) is a characteristic feature of EGID, including IBD 4, 19. Staining of duodenal biopsy specimens with H&E for histopathological evaluation is routinely performed during diagnosis of IBD in dogs 13, 14. In a previous study, we determined that unlike H&E staining, which detects only intact eosinophils, Epx IHC allows reliable identification of intact and degranulated eosinophils in jejunal tissue (collected at necropsy) of dogs with IBD, and potentially could allow quantitative analysis of eosinophils in the small intestine 15.…”

Section: Discussionmentioning

confidence: 99%

“…The assessment of GI mucosal inflammation, including the quantification of eosinophils, by H&E staining of biopsy tissues in conjunction with exclusion of underlying disease is used as a guideline in the diagnosis of IBD 14. However, H&E staining can only detect intact but not degranulated, eosinophils, and therefore may underrepresent the extent of eosinophilic infiltration 15.…”

Section: Introductionmentioning

confidence: 99%

“…However, H&E staining can only detect intact but not degranulated, eosinophils, and therefore may underrepresent the extent of eosinophilic infiltration 15. Although eosinophils are present in the normal small intestinal mucosa, the distinction between the upper limit of normal and abnormally increased tissue eosinophils is not clearly defined using H&E staining 14, 16, 17. Using jejunal tissue collected at necropsy examination from dogs with IBD, we previously have demonstrated that IHC using a mAb specific for the eosinophil granule protein Epx allows reliable morphological identification of degranulated as well as intact eosinophils and could serve as a tool for quantitative evaluation of eosinophils in the small intestine 15.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of eosinophils in gastrointestinal inflammatory disease of dogs

Baştan

Seelig

Day

et al. 2018

Veterinary Internal Medicne

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BackgroundAccurate identification of eosinophils in the gastrointestinal (GI) tract of dogs with eosinophilic GI disease (EGID) by histological evaluation is challenging. The currently used hematoxylin and eosin (H&E) staining method detects intact eosinophils but does not detect degranulated eosinophils, thus potentially underrepresenting the number of infiltrating eosinophils.ObjectiveTo develop a more sensitive method for identifying and quantifying both intact and degranulated eosinophils to diagnose EGID more accurately.MethodsEndoscopically obtained paraffin‐embedded intestinal biopsy specimens from dogs with GI signs were examined. The study groups were dogs with eosinophilic enteritis (EE), lymphoplasmacytic and mixed enteritis, and control dogs with GI signs but no histologic changes on tissue sections. Consecutive sections were immunolabeled with monoclonal antibodies (mAbs) against the eosinophil granule protein eosinophil peroxidase (Epx) and stained by H&E, respectively. The number of eosinophils was manually quantified and classified as intact or degranulated.ResultsThe number of intact eosinophils detected in Epx mAb‐labeled duodenal sections was significantly higher compared with that in H&E‐stained sections, with a similar relationship noted in the colon and stomach. The Epx mAb allowed the unique assessment of eosinophil degranulation. The number of intact and degranulated eosinophils was significantly higher in duodenal lamina propria of the EE and mixed group compared to the control group.ConclusionImmunohistochemical detection of Epx provides a more precise method to detect GI tract eosinophils compared to H&E staining and could be used as an alternative and reliable diagnostic tool for assessment of biopsy tissues from dogs with EGID.

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Gastrointestinal Endoscopy

Neiger¹,

Stengel

2021

Veterinary Endoscopy for the Small Animal Practitioner

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Endoscopic, Biopsy, and Histopathologic Guidelines for the Evaluation of Gastrointestinal Inflammation in Companion Animals

Cited by 313 publications

References 87 publications

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

Clinical utility of currently available biomarkers in inflammatory enteropathies of dogs

Assessment of eosinophils in gastrointestinal inflammatory disease of dogs

Gastrointestinal Endoscopy

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