Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Belgium.
Equine Vet J. 2013 May;45(3):278-83. doi: 10.1111/j.2042-3306.2012.00682.x. Epub 2012 Nov 12.
Equine joint infection is a life-threatening disorder, and confirmation of the diagnosis can be difficult. Synovial fluid biomarkers may assist the discrimination between infectious and noninfectious joint disease.
This study investigates whether the immunological detection of total and enzymatically active myeloperoxidase (MPO) assists the diagnosis of joint infection in horses.
The following 4 sample groups were included: healthy; osteochondritis dissecans (OCD); traumatic synovitis; and culture-confirmed infected joints. Synovial fluid was analysed for total MPO by a horse-specific sandwich enzyme-linked immunosorbent assay (ELISA) and for active MPO using the specific immunological extraction followed by enzymatic detection (SIEFED) technique. Western blot analysis was performed to confirm the antibody specificity.
Synovial fluid from infected joints contained significantly more total and active MPO than samples from healthy joints, joints affected by OCD and joints with traumatic synovitis. Cut-off values were set at 5000 and 350 ng/ml for total and active MPO, respectively, with fair sensitivity, specificity, positive and negative predictive values and likelihood ratios for infection. Correlation coefficients were reported between the total as well as the active MPO levels and the routine synovial fluid parameters, i.e. the white blood cell count, the neutrophil count and the total protein level. No correlation was observed between MPO and either the age of the horse or the joint affected. Western blotting confirmed the antibody specificity for equine MPO.
Synovial fluid MPO was identified as a very promising biomarker to augment the discrimination of infectious vs. noninfectious joint disease in horses. Both ELISA and SIEFED techniques can be used for its specific and rapid detection. The analysis of synovial fluid MPO can be used as a complementary test to aid in the discrimination between infectious and noninfectious joint disease, especially when the white blood cell counts and the total protein level are inconclusive.
马的关节感染是一种危及生命的疾病，确诊较为困难。滑液生物标志物可能有助于区分感染性和非感染性关节疾病。
本研究旨在探讨免疫检测总酶和活性髓过氧化物酶（MPO）是否有助于诊断马的关节感染。
本研究纳入了以下 4 组样本：健康组；剥脱性骨软骨炎（OCD）组；创伤性滑膜炎组；和经培养证实的感染性关节组。使用马专用夹心酶联免疫吸附试验（ELISA）检测滑液总 MPO，使用特异性免疫提取后酶检测（SIEFED）技术检测活性 MPO。进行 Western blot 分析以确认抗体特异性。
与健康关节、OCD 关节和创伤性滑膜炎关节的滑液相比，感染性关节的滑液中总 MPO 和活性 MPO 的含量明显更高。总 MPO 和活性 MPO 的截断值分别设定为 5000 和 350ng/ml，对感染的敏感性、特异性、阳性预测值、阴性预测值和似然比均较好。报告了总 MPO 和活性 MPO 水平与常规滑液参数（即白细胞计数、中性粒细胞计数和总蛋白水平）之间的相关系数。未观察到 MPO 与马的年龄或受影响的关节之间存在相关性。Western blot 证实了针对马 MPO 的抗体特异性。
滑液 MPO 被确定为一种很有前途的生物标志物，可增强马的感染性与非感染性关节疾病的鉴别。ELISA 和 SIEFED 技术均可用于其特异性和快速检测。分析滑液 MPO 可作为辅助检测，有助于区分感染性和非感染性关节疾病，尤其是当白细胞计数和总蛋白水平不确定时。
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