Hoffman C J, McKenzie H C, Furr M O, Desrochers A
Marion duPont Scott Equine Medical Center, Virginia/Maryland Regional College of Veterinary Medicine, Leesburg, VA.
J Vet Intern Med. 2015 Mar-Apr;29(2):626-35. doi: 10.1111/jvim.12558.
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis occurs in horses with systemic inflammatory response syndrome (SIRS). Peripheral resistance to glucocorticoids has not been investigated in horses.
To determine if glucocorticoid receptor (GR) function in horses can be measured using flow cytometry, and to use this information to evaluate HPA axis dynamics.
Eleven healthy adult horses in parts 1 and 2. Ten horses with SIRS and 10 age and sex matched controls in part 3.
Flow cytometry was used to evaluate GR density and binding affinity (BA) in 3 healthy horses in part 1. In part 2, exogenous ACTH was administered to eight healthy horses. Their cortisol response and GR properties were measured. In part 3, CBC, serum biochemistry, cortisol and ACTH, and GR properties were compared between controls without SIRS (n = 10) and horses with SIRS (n = 10), and between survivors and nonsurvivors (n = 4 and n = 6 respectively).
Flow cytometry can be used to measure GR properties in equine PBMCs. No correlation was observed between plasma cortisol concentration and GR density or BA in healthy horses (r = -0.145, P = .428 and r = 0.046, P = .802 respectively). Nonsurvivors with SIRS had significantly decreased GR BA (P = .008). Horses with triglyceride concentration > 28.5 mg/dL had increased odds of nonsurvival (OR=117; 95% CI, 1.94-7,060). GR BA <35.79% was associated with nonsurvival (OR = 30.33; 95% CI, 0.96-960.5).
Tissue resistance to glucocorticoids contributes to HPA axis dysfunction in adult horses with SIRS. These horses might benefit from treatment with exogenous glucocorticoids.
全身炎症反应综合征(SIRS)马匹存在下丘脑 - 垂体 - 肾上腺(HPA)轴功能失调。尚未对马的糖皮质激素外周抵抗进行研究。
确定是否可用流式细胞术检测马的糖皮质激素受体(GR)功能,并利用该信息评估HPA轴动态。
第1部分和第2部分中有11匹健康成年马。第3部分中有10匹患有SIRS的马以及10匹年龄和性别匹配的对照马。
第1部分中,使用流式细胞术评估3匹健康马的GR密度和结合亲和力(BA)。第2部分中,对8匹健康马给予外源性促肾上腺皮质激素(ACTH)。测量它们的皮质醇反应和GR特性。第3部分中,比较无SIRS的对照马(n = 10)和患有SIRS的马(n = 10)之间,以及存活者和非存活者(分别为n = 4和n = 6)之间的全血细胞计数、血清生化、皮质醇和ACTH以及GR特性。
流式细胞术可用于检测马外周血单核细胞(PBMC)中的GR特性。健康马的血浆皮质醇浓度与GR密度或BA之间未观察到相关性(r分别为 - 0.145,P = 0.428和r = 0.046,P = 0.802)。患有SIRS的非存活者GR BA显著降低(P = 0.008)。甘油三酯浓度> 28.5 mg/dL的马非存活几率增加(OR = 117;95% CI,1.94 - 7,060)。GR BA <35.79%与非存活相关(OR = 30.33;95% CI,0.96 - 960.5)。
糖皮质激素的组织抵抗导致成年SIRS马的HPA轴功能障碍。这些马可能从外源性糖皮质激素治疗中获益。