Equine Sarcoid Associated with Cutaneous Habronemosis

Equine sarcoids are benign fibroblastic skin tumors affecting equids worldwide. Infection with bovine papillomavirus types 1 and 2 has been implicated as a major fact in the disease development; however, the cellular mechanisms underlying fibroblast transformation are still largely unknown. In the present study, a diagnosis of sarcoid was histologically assessed along with eosinophilic dermatitis. The sarcoid lesion expressed the viral oncoproteins E5 and E2, suggesting a causative role of the virus and its replication. Ribosomal DNA of the nematode Habronema muscae was also revealed in the lesion. This is the first report to describe and discuss an association of cutaneous habronemosis with equine sarcoid.     

Equine sarcoids: Bovine Papillomavirus type 1 transformed fibroblasts are sensitive to cisplatin and UVB induced apoptosis and show aberrant expression of p53

Bovine papillomavirus type 1 infects not only cattle but also equids and is a causative factor in the pathogenesis of commonly occurring equine sarcoid tumours. Whilst treatment of sarcoids is notoriously difficult, cisplatin has been shown to be one of the most effective treatment strategies for sarcoids. In this study we show that in equine fibroblasts, BPV-1 sensitises cells to cisplatin-induced and UVB-induced apoptosis, a known cofactor for papillomavirus associated disease, however BPV-1 transformed fibroblasts show increased clonogenic survival, which may potentially limit the therapeutic effects of repeated cisplatin treatment. Furthermore we show that BPV-1 increases p53 expression in sarcoid cell lines and p53 expression can be either nuclear or cytoplasmic. The mechanism and clinical significance of increase/abnormal p53 expression remains to be established.     

BPV-1 infection is not confined to the dermis but also involves the epidermis of equine sarcoids

In equids, bovine papillomaviruses of type 1 (BPV-1) and less frequently type 2 induce common, locally aggressive skin tumours termed sarcoids. Whereas BPV infection in cattle usually involves the epidermis and is productive in this skin layer, infection in equids is currently thought to be abortive, with virus solely residing as multiple episomes in dermal fibroblasts. Based on recent observations that do not agree with this assumption, we hypothesised that BPV also infects equid epidermis and is active in this skin layer. To test this hypothesis, we conducted a proof-of-principle study on eight distinct sarcoids. Presence of viral DNA was addressed by qualitative and quantitative BPV-1 PCR from microdissected sarcoid epidermis, and by subsequent amplicon sequencing. Viral activity was assessed by screening sarcoid epidermis for BPV-1 protein expression using immunohistochemistry (IHC) or immunofluorescence (IF). Virus-free equine skin served as negative control throughout the assays. BPV-1 DNA was demonstrated in all sarcoid epidermis samples, with viral DNA loads ranging between 2 and 195 copies/cell. Identical BPV-1 E5 genes were identified in epidermis and dermis of each of two sarcoids, yet different E5 variants were found in individual lesions. IHC/IF revealed the presence of E5 and E7 protein in sarcoid epidermis, and L1 capsomers in the squamous layer of one lesion. These findings indicate that BPV infection also involves the epidermis, where it may occasionally be productive.     

Polymerase chain reaction analysis of the surgical margins of equine sarcoids for bovine papilloma virus DNA

OBJECTIVE: To examine apparently normal skin around equine sarcoids for evidence of bovine papilloma virus (BPV) DNA, and to relate this finding to the observed recurrence after surgery. STUDY DESIGN: Prospective study. ANIMALS OR SAMPLE POPULATION: Forty-one equine sarcoids from 19 horses. MATERIALS AND METHODS: The tumors were surgically excised at a measured distance of 8, 12, or 16 mm. Samples from the tumor and of the entire surrounding skin were taken at 4, 8, 12, and 16 mm from the tumor border and analyzed for the presence of BPV DNA using polymerase chain reaction (PCR) amplification. The samples were grouped per examined sarcoid, and a tumor was considered positive at a certain distance as soon as at least one of the samples at that distance was positive. The clinical outcome was recorded for each sarcoid after a minimal follow-up of 6 months. RESULTS: All sarcoids were positive for BPV(1) or BPV(2). The tumor margin was positive at 4, 8, 12, and 16 mm in, respectively, 95%, 73%, 39%, and 33% of the examined sarcoids. Local recurrence was observed in 3 sarcoids on 3 different horses. From survival analysis, there was a greater likelihood for local recurrence when sarcoids had a surgical margin that was positive for BPV DNA. CONCLUSIONS AND CLINICAL RELEVANCE: BPV DNA is often detected in visibly normal skin around sarcoids, and there is a significantly greater probability for local recurrence when the surgical margins are positive for the presence of BPV DNA.     

Treatment of periocular and non-ocular sarcoids in 18 horses by interstitial brachytherapy with iridium-192

Treatment of the equine sarcoid has posed a significant challenge to clinicians for years and many different methods have been tried with varying success, including ionising radiation. The aim of this study was to review the efficacy of iridium-192 interstitial brachytherapy for the treatment of eight periocular sarcoids and 15 non-ocular sarcoids on 18 horses. All the periocular sarcoids and 13 of the 15 non-ocular sarcoids were treated successfully.     

Immediate Split-Thickness Autogenous Skin Grafts in the Horse Case Reports on the Treatment of Equine Sarcoids in 3 Horses

Three horses with equine sarcoids were treated with radical surgical excision and immediate split-thickness skin grafts. Graft take ranged from 50 to 100%, and the epithelial coverage attained resulted in an early functional repair. In no instance was there a recurrence of the sarcoid.     

Detection of bovine papillomavirus DNA on the normal skin and in the habitual surroundings of horses with and without equine sarcoids

The purpose of the present study was to examine whether bovine papillomavirus (BPV) DNA can be detected on the normal skin and in the habitual surroundings of horses with and without equine sarcoids by means of superficially taken swabs. In affected horses, no significant difference in presence of BPV-DNA could be observed between samples obtained from the equine sarcoid surface, from normal skin close to the tumour and from a normal skin site in direct contact with the tumour. From the group of healthy horses living in contact with affected horses, 44% were BPV-DNA positive. The surroundings of affected and non-affected horses are probably not a major source of BPV-DNA contamination. It can be concluded that BPV-DNA is present on the normal skin of horses affected by equine sarcoid and to a lesser degree, on the normal skin of horses living in contact with affected horses.     

Surface antigens on equine sarcoid cells and normal dermal fibroblasts as assessed by xenogeneic antisera

To characterise the expression of surface antigens on equine sarcoid cells compared to normal equine fibroblasts, immune sera were produced in rabbits against transformed cells of a virus-containing sarcoid cell line (Mc-1) and normal dermal fibroblasts, respectively. The specificities of the sera were analysed by antibody-dependent cellular cytotoxicity against 51Cr-labelled target cells using human lymphocytes as effector cells. Anti-Mc-1 antiserum induced strong cytotoxicity against transformed cells of two sarcoid cell lines (Mc-1 and Bay Mc-1), whereas the cytotoxicity against transformed cells of equine testis, or against cells grown in short term or primary cultures derived either from sarcoids or normal dermis was low or absent. In contrast, anti-normal dermal fibroblasts antiserum did not induce antibody-dependent cellular cytotoxicity against Mc-1 or Bay Mc-1 but reacted strongly against both normal fibroblasts and primary cultured cells derived from sarcoids. The apparent specificity of the anti-Mc-1-induced cytotoxicity was confirmed by absorption of the anti-serum with either normal dermal fibroblasts and equine testis cells or Mc-1 cells. Immunoprecipitation of 125I-surface labelled Mc-1 cells by absorbed anti-serum and analysis by SDS-PAGE and autoradiography revealed that anti-Mc-1 antibodies reacted with at least four surface components with a wide range of molecular weights. Immunofluorescence with rabbit anti-human beta 2mu serum indicated that Mc-1 cells in contrast to equine lymphocytes and fibroblasts did not express class 1 major histocompatibility complex antigens.(ABSTRACT TRUNCATED AT 250 WORDS)     

Bovine papillomavirus DNA can be detected in keratinocytes of equine sarcoid tumors

Bovine papillomavirus (BPV)-1 and -2 is linked to equine sarcoids, a commonly observed skin tumor in horses that is of considerable veterinary importance. Previous studies using in situ hybridization have detected BPV DNA only in fibroblasts and not in keratinocytes of sarcoids. In contrast, normal equine skin latently infected with BPV shows a dysplastic epithelium without dermal changes, similar to lesions induced by other papillomavirus types infecting the epithelium. The first goal of our study was to describe the epidermal and dermal characteristics of several stages in sarcoid development. Next, we explored whether BPV can infect epidermal cells in the horse using real-time PCR on laser-micro-dissected keratinocytes and fibroblasts. We found that latently infected normal skin samples and a subset of early stage sarcoids show dysplastic, koilocyte-like epithelial changes. BPV DNA was detected in keratinocytes in 40% of the samples with these particular epithelial properties, whereas advanced sarcoids only had BPV DNA in the fibroblasts. These data may indicate a novel and intriguing pathway of BPV infection in the horse composed of a first step of keratinocyte infection, followed by migration of viral material towards the dermis resulting in infection of sub-epidermal fibroblasts and their fully transformed phenotype. Additionally, an example of co-existence of a dermal BPV-1 and an epidermal BPV-2 infection in the same lesion is shown, indicating that horses can harbor infection with more than one BPV type at the same time.     

Amplification of feline sarcoid‐associated papillomavirus DNA sequences from bovine skin

Feline sarcoids are uncommon dermal neoplasms that are thought to be caused by papillomaviral (PV) infection. Feline sarcoid‐associated PV (FeSarPV) has been consistently detected in sarcoids from North American and New Zealand cats but has not been detected within any other feline sample. This suggests that feline sarcoids may develop due to cross‐species infection by a PV from an unidentified reservoir host. While there is some epidemiological evidence to suggest that cattle are the reservoir host of FeSarPV, this PV has never been identified within any bovine sample. In this study both consensus PCR primers and primers specific to FeSarPV were used to investigate the presence of PV DNA within five fibropapillomas and 18 samples of inflammatory skin disease from cattle. Consensus primers amplified bovine PV‐2 DNA from four fibropapillomas, but none of the dermatitis samples. However, specific primers amplified FeSarPV DNA from four fibropapillomas and five inflammatory skin lesions. To the best of our knowledge this is the first time that FeSarPV has been detected within any sample other than a feline sarcoid. The ability of FeSarPV to asymptomatically infect bovine skin suggests that cattle are the reservoir host of this PV and feline sarcoids could be the result of cross‐species infection of a dead‐end host by a bovine PV.     

Glycolysis inhibition improves photodynamic therapy response rates for equine sarcoids

Photodynamic therapy (PDT) holds great promise in treating veterinary and human dermatological neoplasms, including equine sarcoids, but is currently hindered by the amount of photosensitiser and light that can be delivered to lesions thicker than around 2 mm, and by the intrinsic antioxidant defences of tumour cells. We have developed a new PDT technique that combines an efficient transdermal penetration enhancer solution, for topical delivery of 5‐aminolevulinic acid (ALA) photosensitiser, with acute topical post‐PDT application of the glycolysis inhibitor lonidamine. We show that the new PDT combination treatment selectively kills sarcoid cells in vitro, with repeated rounds of treatment increasing sarcoid sensitisation to PDT. In vivo, ALA PDT followed by 600 μM lonidamine substantially improves treatment outcomes for occult, verrucous, nodular and fibroblastic sarcoids after 1 month (93% treatment response in 27 sarcoids), compared with PDT using only ALA (14% treatment response in 7 sarcoids).     

A review of equine sarcoid

Equine sarcoid is the most common tumour of horses and accounts for over half of all equine skin tumours. Six types of sarcoid based on gross appearance and clinical behaviour have been described including occult, verrucous, nodular, fibroblastic, mixed and malevolent. Common locations for sarcoid development include the periocular region, ear pinnae, lips, neck, extremities and ventrum (including groin region). Bovine papillomavirus (BPV) is causally associated with equine sarcoid with genetic haplotype, fly vectors and skin trauma identified as potential risk factors for development of the disease. Histopathology is required for definitive diagnosis of equine sarcoid but incomplete excision is thought to activate latent BPV and stimulate growth. Although there are no uniformly effective treatment options, several modalities have been successful in eliminating or managing equine sarcoid. Surgical excision, intratumoural chemotherapy, cryotherapy, hyperthermia, radiotherapy, immunotherapy and immune modulators are used with degrees of success relative to the accessibility and invasiveness of the tumour. Prevention of equine sarcoid may be facilitated by future development of vaccines against bovine papillomavirus.     

Prevalence and body distribution of sarcoids in South African Cape mountain zebra (Equus zebra zebra)

There are no reports in the literature describing any tumours, and specifically sarcoids, in zebras. The equine sarcoid, a locally aggressive, fibroblastic skin tumour, is the most common dermatological neoplasm reported in horses. The Cape mountain zebra (CMZ) has been described as one of the most vulnerable mammals in South Africa with current populations existing in isolated units. All South African CMZ are descendants from no more than 30 individual animals originating from 3 populations, namely the Mountain Zebra National Park, and Kammanassie and Gamka Mountain Nature Reserves near Cradock. The possibility therefore exists that the existing populations arose from a very small gene pool and that they are considerably inbred. A reduction in major histocompatibility complex diversity due to genetic bottlenecks and subsequent inbreeding probably contributed to uniform population sensitivity and the subsequent development of sarcoid in two CMZ populations, namely in the Bontebok National Park and Gariep Nature Reserve. The entire population of CMZ in the Bontebok National Park was observed and sampled during 2002 to document the prevalence and body distribution of sarcoids. During the same year, a comparative study was carried out on an outbred population of Burchell's zebra in the Kruger National Park. The prevalence in CMZ in the Bontebok National Park was 53 %, while the Burchell's zebra in Kruger National Park had a prevalence of 1.9 %. The most common sites for sarcoid in CMZ were the ventral abdomen and limbs. Prevalence of sarcoids in horses recorded in the literature varies between 0.5 % and 2 %. The Gariep Nature Reserve recently reported a prevalence of almost 25 % in CMZ in the reserve.     

Bovine papillomavirus infection in equine sarcoids and in bovine bladder cancers

Bovine papillomavirus (BPV) type 2 is involved in carcinogenesis of the urinary bladder in cattle, while BPV-1 is commonly associated with equine sarcoid tumours. In both cases the early viral proteins are expressed, but virion is not produced. Given the similarities in BPV biology between the tumours in cattle and horses, bovine bladder cancers and equine sarcoids were compared with respect to physical status, load of viral DNA and variability of the E5 open reading frame (ORF). Rolling circle amplification demonstrated that BPV-1 and BPV-2 genomes exist as double stranded, episomal, circular forms in the two tumours. Realtime quantitative PCR revealed that equine sarcoids contained higher viral DNA loads compared to bovine bladder cancers. The BPV-1 E5 ORF showed sequence variation but BPV-2 ORF did not. The presence of BPV-1 E5 variations or their absence in the BPV-2 E5 ORF does not appear to have an effect on viral DNA load in either tumour type.     

The efficacy of intratumoural 5-fluorouracil for the treatment of equine sarcoids

OBJECTIVE: To document the efficacy of intratumoural injections of 5-fluorouracil for the treatment of equine sarcoids. DESIGN: A prospective study that included 13 horses and one donkey. PROCEDURE: Sarcoids were confirmed by histological examination and treated with intratumoural 5-fluorouracil every 2 weeks. If the sarcoids did not resolve after seven treatments, treatment was considered a failure. All cases were re-examined 6 months after treatment commenced and owners were telephoned 3 years after commencement of treatment to report on tumour recurrence. Outcome comparisons were performed to determine the effect of previous treatment, tumour size and tumour location on sarcoid resolution. The efficacy of intratumoural 5-fluorouracil was compared with other previously documented treatments of equine sarcoids. RESULTS: Sarcoids smaller than 13.5 cm3 were significantly (P = 0.032) more likely to resolve with treatment than larger sarcoids. Sarcoids that were not responsive to previous therapies were significantly (P = 0.007) more likely to recur after 3 years than sarcoids that had not been treated prior to this study. In this study, there were similar rates of resolution in cases with mutiple tumours (66.6%) when compared to cases with single tumours (60%). The numbers in this study were too small to properly evaluate the effect of tumour location on the success of treatment. Intratumoural 5-fluorouracil appeared to have resolved sarcoids in 9 of 13 cases (61.5%) as determined by follow up conversation with the owners 3 years after the initial treatment. CONCLUSION: The use of intratumoural 5-fluorouracil compares favourably with other treatment modalities for sarcoids, with a long term successful resolution rate of 61.5%. Owners should be warned that resistant sarcoids and sarcoids larger than 13.5 cm3 have a poorer prognosis for resolution and more aggressive therapeutic options should be considered.     

Pathomorphological and immunohistochemical study of selected markers of tumour cell proliferation in equine sarcoids

The purpose of the study was a pathomorphological and immunohistochemical analysis of tumour cells and connective tissue in equine sarcoids. Investigations were performed using histopathological, ultrastructural, immunohistochemical (PCNA, p53, cytokeratin, vimentin) and histochemical (Ag-NORs) methods. The study was conducted on 50 sarcoids originating from 36 horses and classified as occult, verrucous, fibroblastic and a mixed type of sarcoid based on their clinical appearance. Most of the tumours were located on the girth (30%), neck (24%), head (12%), and legs (12%). The average age of the horses at the first clinical examination was 5.7 years. The sarcoids occurred on the skin of mares (61%), geldings (31%) and stallions (8%), the predominant was Wielkopolska breed (41%) and mixed breeds with Wielkopolska breed (41%). The predominant colour was bay (80%). The data showed that the presence of characteristic, microscopic features was variable but it was not consistent enough to allow differentiation of the clinical types based on histopathology. PCNA expression was not characteristic for the clinical type of sarcoid but it appeared to be a useful tool for the determination of the biological activity of the tumour and the probability of its recurrence. No relationship was found between AgNORs and cell proliferation. The study demonstrated the presence of p53 positive cells in the epidermal and fibroblastic portions. Numerous p53-positive cells were observed in the sarcoids and tended to recurrence. The staining for cytokeratin and vimentin makes the diagnosis of tumour easier. The immunohistochemical studies of PCNA, and p53 are of great significance to the prognosis.     

Association between equine leucocyte antigens (ELA) and equine sarcoid tumors in the population of Swedish halfbreds and some of their families

The distribution of equine leucocyte antigens (ELA) in Swedish Halfbreds affected by sarcoid tumors was determined and compared with that of control horses of the same breed. ELA-haplotype A3W13 appeared more frequently in affected horses, resulting in a chi 2 value of 4.45 (P = 0.034) for A3 and 9.05 (P = 0.0026) for W13, respectively. The relative risk factor (RR) could be estimated to 2.13 and 3.00 for A3 and W13, respectively. The etiology fraction (EF) was calculated to 28% and 37% for A3 and W13, respectively. Thus, in the population of Swedish Halfbreds approximately 40% (at least) of the disease appeared to be associated with the genetic background of the affected horse. Family studies established that ELA are codominantly expressed and inherited as simple Mendelian traits and that sarcoids among offspring are significantly associated with one of the parental haplotypes (P = 0.00942). This parental haplotype does not always include A3W13. These results confirm and extend previous results from other breeds and strongly suggest the existence of a predisposition for sarcoids among horses, that is due to an autosomal, dominant, ELA-linked gene with incomplete penetrance. In extension, this indicates a multifactorial etiology of equine sarcoids (additional non-MHC gene(s) and/or environmental factors).     

Factors associated with the risk of developing sarcoid tumours in horses.

A retrospective case-control study was conducted to identify risk factors in horses associated with the development of the common skin tumours known as sarcoids. The study involved 503 sarcoid cases diagnosed (January 1980-December 1989) at New York State College of Veterinary Medicine and a similar number of controls (non-sarcoid cases). Data on age, breed and sex of cases and controls were obtained from computerised records. Multiple logistic regression analysis was used to identify risk factors. Separate data were obtained for the same 10-year period from the Veterinary Medical Data Program to determine the proportional morbidity rate at different veterinary colleges in North America. Appaloosa, Arabian and Quarter horses were at a higher risk of developing sarcoid tumours than were Thoroughbred horses. Standardbred horses had a lower risk of developing sarcoids. Geldings were at a higher risk of developing sarcoids in comparison with stallions. There was no significant difference in the risk of developing sarcoids between stallions and mares. The risk of developing sarcoid increased with age up to 15 years and then declined. The proportional morbidity rate of sarcoids among the veterinary colleges ranged between 0 and 14 per 1,000 cases, with an average of 6 per 1,000.