Identification and characterisation of the major antiproteases in equine serum and an investigation of their role in the onset of chronic obstructive pulmonary disease (COPD).

Three major antiprotease components in equine serum were identified and characterised. These were the acidic prealbumin Pr, the homologue of human alpha-1 antitrypsin and 2 protease binding proteins, the acidic prealbumin Xc and alpha-2 macroglobulin, both capable of inhibiting the proteolytic activity of trypsin, but with only limited inhibitory effect on its esterolytic activity. The possible role of these serum antiproteases in the onset of chronic obstructive pulmonary disease (COPD), analogous to the hereditary dysproteinaemia of alpha-1 antitrypsin in man, was investigated. There was no evidence of a genetically determined variation in the protease binding proteins but an increased frequency of the electrophoretically slower Pr antitrypsin alleles was present in horses affected with COPD. However, because of both the mixed breeding of the animals investigated and the lack of correlation with low serum trypsin inhibitory capacity, measured by inhibition of DL-BAPA hydrolysis, the significance of this observation could not be critically assessed.     

An investigation of the incidence of chronic obstructive pulmonary disease (COPD) in random populations of Swiss horses

The incidence of Chronic Obstructive Pulmonary Disease (COPD) in Switzerland was determined in three groups of horses selected at random. Group A (97 horses) and Group B (93 horses) had no history of respiratory disease, but Group C (113 horses) had a history of lower respiratory tract disease. All horses were examined by auscultation of the respiratory tract under forced breathing, endoscopic examination of the upper and lower respiratory tract, arterial blood gas analysis at rest and cytological examination of respiratory secretions (RS). Fifty-four per cent of the horses in Group A and 54.8 per cent of Group B were diagnosed as suffering clinical COPD and only 12.4 per cent of horses in Group A and 8.6 per cent in Group B had no detectable abnormalities in their lower respiratory tracts. In Group B, 19.4 per cent were considered to be suffering from parasitic pulmonary disease indicated by elevated numbers of eosinophils in their RS. Pharyngeal lymphoid hyperplasia was exhibited in 70.1 per cent of Group A and 74.2 per cent of Group B. Cytological examination of RS was useful to determine if the secretions found in the trachea originated from the upper or lower respiratory tract. Arterial blood gas analysis revealed no significant differences between healthy horses and those with subclinical or mild COPD.     

Chronic obstructive pulmonary disease (COPD): factors influencing the occurrence.

Breed, age, weight, type of work performed, seasonal onset, poor ventilation and exposure to moulds in the habitat were investigated in relation to the occurrence of chronic obstructive pulmonary disease (COPD). COPD was most commonly detected in showjumping and hacking horses. The older a horse, the more likely it was to become affected although most were 6 to 10 years of age. Of the horses in this sample of the population, which was not a random one, thoroughbred horses were affected least and ponies most often. The high incidence in ponies was related to their more frequent exposure to poor quality fodder and bedding. Most horses are exposed to the hazard of moulds, but more affected horses were so exposed than those not affected with COPD. Poor ventilation of the stable increased the chance of a horse becoming affected. Sex, body weight and season of onset of coughing had no influence on the occurrence of the disease.     

The presence of precipitating antibodies in the sera of horses with chronic obstructive pulmonary disease (COPD).

The sera of horses affected and not affected with chronic obstructive pulmonary disease (COPD) were examined for precipitins to Micropolyspora faeni and Aspergillus fumigatus. Precipitins to both antigens were not restricted to COPD cases but occurred more frequently in animals affected with COPD. Many animals without detectable precipitins responded clinically to inhalation challenge with these antigens.     

The effects of sodium cromoglycate on antigen inhalation challenge in two horses affected with chronic obstructive pulmonary disease (COPD)

80 mg sodium cromoglycate (SCG) was administered by inhalation to two COPD-affected animals known to have respiratory hypersensitivity to Micropolyspora faeni. SCG treatment 20-30 minutes prior to inhalation challenge with M. faeni prevented exacerbation of respiratory disease, usually seen 4-8 hours after challenge. duration of protection against antigen challenge after a single SCG treatment was 4-5 days. The duration of protection was not prolonged by reducing the frequency of antigen challenge. Multiple antigen challenge, using M. faeni and Aspergillus fumigatus, shortened the protective period of SCG to 3 days.     

Ultrastructural findings in horses with chronic obstructive pulmonary disease (COPD). I: Alterations of the larger conducting airways

Extensive light and electron microscope studies of the conducting airways were carried out in 28 horses with varying degrees of clinically manifested chronic obstructive pulmonary disease (COPD) and in 8 horses with normal lungs. The principal ultrastructural changes were found in the ciliated cells. There was focal loss of ciliated cells, which were replaced by undifferentiated cells in a largely hyperplastic epithelium, and some horses, independent of the degree of severity of the disease, showed various types of ciliary malformation. The finding of dilated intercellular clefts and accumulations of mast cells was interpreted as morphological evidence of non-specific mucosal hyperreactivity. Interstitial cells with intracytoplasmal crystal inclusions, the cause of which is not clear, were seen in many horses. Comparison between the clinical diagnosis and the morphological findings showed partial correlation. The ciliary loss, the appearance of peribronchial inflammatory processes and the occurrence of intracytoplasmic crystalline inclusions showed a positive correlation. In 12 of 28 cases, the severity of clinical diagnosis agreed with the degree of the morphological findings. The changes in the conducting airways were interpreted pathogenetically as reactive processes to changes in the small airways in the course of equine COPD.     

A study of the effect of a platelet activating factor (PAF) receptor antagonist on antigen challenge of horses with chronic obstructive pulmonary disease

Antigen challenge involving exposure to straw and mouldy hay for 7 h produced lung function changes and neutrophil recruitment to the lungs in horses with chronic obstructive pulmonary disease (COPD). During the challenge, an increase in radiolabelled neutrophils in the lungs occurred, together with increased respiratory rate and pleural pressure. The role of platelet activating factor (PAF) in antigen-induced neutrophil accumulation, and increased pleural pressure and respiratory rate was investigated by administering the PAF receptor antagonist WEB 2086 to asymptomatic COPD horses prior to antigen challenge. WEB 2086 (3 mg/kg i.v.) did not affect antigen-induced changes in either neutrophil accumulation or respiratory function. These results suggest that PAF may not be an important mediator of the response to antigen in equine COPD.     

Ultrastructural findings in horses with chronic obstructive pulmonary disease (COPD). II: Pathomorphological changes of the terminal airways and the alveolar region

Extensive light and electron microscope studies (transmission and scanning electron microscopy) of the bronchioles and alveolar region, in 28 horses suffering chronic obstructive pulmonary disease (COPD) and eight control horses, revealed good correlation between clinical severity and morphological changes. In the bronchiolar epithelium the non-ciliated bronchiolar epithelial (Clara) cells, in particular, showed ultrastructural alterations and, even in the mild stages of disease, these presented degenerative changes and lack of differentiation. Together with loss of granulation in the Clara cells and metaplasia of the goblet cells, cells were seen with unusual intracytoplasmic lamellar inclusion, the number of which increased sharply with clinical severity. The focal changes in the alveolar region were necrosis of type I epithelial cells, alveolar fibrosis of varying degrees with type II epithelial transformation and emphysema or hyperinflation, with an increase in Kohn's pores. Some horse also showed morphological signs of interference with the surfactant system, in the form of marked cysts with lamellar structure. The alveolar changes were mostly in the peribronchiolar region and were, therefore, interpreted as reactive processes. No conclusions as to the aetiology of equine COPD can be derived from these morphological investigations.     

Alveolar clearance in horses with chronic obstructive pulmonary disease

OBJECTIVE: To assess sensitivity of scintigraphic alveolar clearance rate as an indicator of alveolar epithelium damage in horses. ANIMALS: 5 healthy horses (group A) and 5 with chronic obstructive pulmonary disease (COPD; group B). PROCEDURE: Horses underwent clearance rate (k [%/min]) determination. Clearance rate of group-B horses was determined after remission of the disease following 2 months at pasture (remission 1), stabling in a controlled environment (remission 2), and during crisis induced by exposure to moldy hay and straw. Methacholine challenge test was performed at each investigation period to determine nonspecific pulmonary airway hyperresponsiveness. Pulmonary function tests (PFT) also were performed, and cell populations in bronchoalveolar lavage (BAL) fluid were determined on another occasion. RESULTS: Group-B horses had significantly faster mean clearance rate during crisis (k = 4.30+/-0.95%/min), compared with that for remission 1(k = 1.98+/-0.55%/min), which did not differ from the rate in group-A horses (k = 1.95+/-0.33%/min). Despite lack of clinical signs of COPD during remission when stabled in a controlled environment, an intermediate value was found (k = 3.20+/-0.72%/min). CONCLUSIONS: This technique allowed grading of lung damage induced by COPD, whereas use of PFT and determination of BAL fluid cell populations failed to differentiate between remission 1 and remission 2. CLINICAL RELEVANCE: Determination of alveolar clearance rate by use of scintigraphy is a sensitive indicator of lung damage. A modified clearance rate was found despite the lack of clinical and functional changes.     

Increased local IgA production in chronic obstructive pulmonary disease

The immunoglobulin (Ig) content of serum and tracheal lavage fluid was measured in 50 horses suffering from chronic obstructive pulmonary disease (COPD) and 40 control horses. The mean immunoglobulin: albumin ratios of the lavage fluids of both groups were significantly higher than the corresponding values for serum, which indicates significant local production of immunoglobulins in the lower respiratory tract. The IgA: albumin ratio of lavage fluid was significantly higher in diseased compared with normal horses, which implies increased local production of IgA in this disease. The IgG: albumin and IgM: albumin ratios of lavage fluid were not significantly different in the two groups of horses. These results reveal an involvement of the respiratory mucosal immune system in COPD.     

Effects of cromolyn in horses with chronic obstructive pulmonary disease

The effect of disodium cromoglycate (cromolyn) in preventing the pulmonary dysfunction caused by the inhalation of barn and hay dust was studied in 5 horses with confirmed chronic obstructive pulmonary disease (COPD). The horses were studied before (Con) and after exposure to hay and dust allergens (Expos) and after pretreatment with cromolyn followed by exposure (Cr-Expos).There was a significant reduction in PaO₂ from 86.8±8.3 to 73.1±8.8 when the horses were exposed to hay and dust allergens. The PaO₂ after pretreatment with cromolyn and exposures was 78.1±5.5. There were no significant changes in PaCO₂, FRC, pH and A-aDO₂ when the Con, Expos, and Cr-Expos periods were compared.There were significant increases in V_E from a control value of 77.9±18.2 to 128.7±55.1 and 133.7±17.1 L/min during the exposures, which was due primarily to increases in respiratory frequency. Respiratory dead space (V_D/V_T) increased from 0.55±0.10 to 0.71±0.07 and 0.65±0.05, and alveolar ventilation (V_E) remained constant. Pulmonary resistance (R_L) and transpulmonary pressure (P_tr) increased from a control of 0.77±0.28 cm H₂O/L/sec and 7.73±3.38 cm H₂O to 2.93±1.01 and 20.17±4.81 during the Expos period and tidal volume (V_T) fell from 7.5±1.0 to 5.7±1.3 L. The pre-treatment with cromolyn before exposures significantly reduced the increase in R_L and P_tr and returned V_T to Con levels.Supported by Fisons, Ltd, Pharmaceutical Division and the Pennsylvania State Horse Racing Commission     

Elastase-producing microorganisms in horse lungs: their possible role in the pathogenesis of chronic pulmonary disease in the horse

Seventeen out of 21 horses had pulmonary microbial organisms which reached considerable numbers in seven cases. Elastase-producing microorganisms from the environment (Streptomyces species and to a lesser extent Bacillus species) constituted 22 per cent to 99 per cent (mean 79 per cent) of the total growth. There was a considerable number of microorganisms with in vitro-produced elastases which were not or only slightly affected by horse serum. There was no correlation between numbers of organisms and pulmonary histopathological findings thus the significance of these microorganisms in the pathogenesis of alveolar emphysema is unknown. The growth of a strain of Streptomyces collinus/diastatochromogus isolated from the lungs was suppressed by fresh horse serum but not by decomplemented horse serum. Complement activation in response to this organism could contribute to airway inflammation through the production of mediators.     

Effects of environmental control on pulmonary function of horses affected with chronic obstructive pulmonary disease

The effects of environmental control on horses affected with chronic obstructive pulmonary disease was assessed by clinical examination and pulmonary function tests, ie, maximum change in intrathoracic pressure, tidal volume, minute volume, non-elastic work of breathing, dynamic compliance, inspiratory and expiratory flow rates and arterial blood gas analysis. A controlled environment (ie, bedding horses on shredded paper and feeding a complete cubed diet) caused symptomatic COPD affected horses to become asymptomatic within four to 24 days (mean ± sd 8.4 ± 4.8 days). When asymptomatic, their pulmonary function values did not differ significantly from those of normal horses, which indicates that the pathophysiological changes occurring in equine COPD are reversible. The time taken for horses to become asymptomatic correlated significantly with age, duration of illness and severity of disease as adjudged by the non-elastic work of breathing.     

Chronic obstructive pulmonary disease (COPD) in horses: aetiological studies: responses to intradermal and inhalation antigenic challenge.

Micropolyspora faeni and Aspergillus fumigatus were identified as common causes of respiratory hypersensitivity in horses affected with chronic obstructive pulmonary disease (COPD). Rye grass pollen and an Actinomycete evoked respiratory allergy in a few horses. Not infrequently, individual horses were found to have respiratory hypersensitivity to two or more antigens. The methods used to examine for allergy were intradermal testing and inhalation challenge with environmental antigens. An intradermal test using an M faeni extract was demonstrated to be suitable for diagnostic use in horses previously accurately diagnosed as suffering from COPD. In contrast, the A fumigatus antigen used proved unsatisfactory for such a purpose. Skin reaction to M faeni and A fumigatus extracts by horses affected with COPD indicated that the hypersensitivity was a dual one--a weak response shortly after injection followed by an Arthus-like response 4 to 8 hours later. As a parameter for monitoring responses to inhalation challenge, maximum intrathoracic pressure change (max delta Ppl) proved satisfactory, whereas changes in partial pressure of arterial oxygen (PaO2) did not.     

Phosphodiesterase activity in neutrophils from horses with chronic obstructive pulmonary disease

Neutrophils are recruited to the lungs of horses with chronic obstructive pulmonary disease (COPD) and exhibit increased activity after antigen challenge. Phosphodiesterase type4 (PDE4) inhibitors have been shown to attenuate human neutrophil activation. The aim of this study was to establish the PDE isoenzyme profile of equine neutrophils using isoenzyme selective inhibitors to determine if these compounds should be evaluated in horses with COPD. Total cAMP and cGMP dependent PDE activity was no different in neutrophils from normal (156.2+/-7.1 and 6.8+/-0.6 pmol/min/mg for cAMP and cGMP, respectively) and COPD susceptible horses (146.0+/-10.2 and 5.5+/-0.6 pmol/min/mg for cAMP and cGMP, respectively). The PDE4 inhibitors, CDP840 and rolipram, caused significant, concentration related and almost complete inhibition of PDE activity (IC(50) values=8.8+/-0.1 x 10(-9) and 7.3+/-0.2 x 10(-9)M for CDP840; 1.2+/-0.1 x 10(-6) and 1.1+/-0.1 x 10(-6)M for rolipram in normal and COPD susceptible horses, respectively). The inhibitory effects of the mixed PDE3/ PDE4 inhibitor, zardaverine were of similar magnitude and potency to rolipram. However, the limited inhibitory effects of the PDE3 inhibitor, siguazodan, suggest that zardaverine is acting primarily via PDE4 inhibition. These results indicate that PDE4 is the predominant isoenzyme present in the equine neutrophil and inhibition of PDE activity using selective PDE4 inhibitors may, therefore, modulate equine neutrophil activation in horses with COPD.     

Efficacy of montelukast in the treatment of chronic obstructive pulmonary disease in five horses

Five horses with moderate to severe chronic obstructive pulmonary disease (COPD) were treated with 0.11 (0.01) mg/kg bodyweight of montelukast, a cysteinyl leukotriene receptor antagonist, once a day for 26 days. The horses were evaluated clinically and endoscopically and subjected to arterial blood gas analysis and lung function tests before and after the period of treatment, and the plasma concentrations of montelukast were determined by high-performance liquid chromatography with fluorescence detection. The treatment did not result in statistically significant differences in the total scores of clinical and endoscopical signs, or in the difference in the arterioalveolar partial pressure of oxygen, maximal changes in pleural pressure, pulmonary resistance or dynamic compliance. The mean (sd) peak plasma concentration (C(max0) of montelukast was 12 (4) ng/ml and was reached 66 (13) minutes (t(max)) after its oral administration. The dose of montelukast per kg bodyweight was approximately the same as that for human beings, but the C(max) in the horses was 28 times lower and the t(max) was reached in one-fifth of the time, suggesting that its oral bioavailability may be lower.     

The role of allergy in chronic pulmonary disease of horses

Twenty-five horses with chronic pulmonary disease were skin tested with allergenic extracts of 24 molds, 4 thermophilic actinomyces, barn dust, hay dust, soya-bean mill dust, and grain mill dust. The results were compared with those obtained on 25 normal horses. Between the 2 groups of horses, there was a highly significant difference in positive skin test results at 30 minutes and 4 hours.     

Climatic and aeroallergen risk factors for chronic obstructive pulmonary disease in horses

OBJECTIVE: To estimate the association between climate and airborne pollen and fungal factors and chronic obstructive pulmonary disease (COPD) in horses. SAMPLE POPULATION: Data from 1,444 horses with a diagnosis of COPD. PROCEDURE: The Veterinary Medical Database was used to identify records of horses admitted to veterinary teaching hospitals in the United States and Canada between 1990 and 1999. Rainfall, mean minimum and maximum temperature, and maximum monthly pollen and fungal spore (mold) counts recorded at the city closest to where the hospital is located were identified for each month data were reported to the Veterinary Medical Database. Associations between climatic and aeroallergen data and monthly prevalence of COPD were estimated by use of cross-correlation and logistic regression models. RESULTS: Significant positive correlations were found between prevalence of COPD and rainfall 3 months previously, minimum temperature 1 and 2 months previously, total pollen counts measured 3 months previously, and total mold counts measured during the same month and 1 month previously. CONCLUSIONS AND CLINICAL RELEVANCE: Outdoor aeroallergens and climatic factors may contribute to the occurrence of COPD in horses.