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免疫介导性溶血性贫血、血小板减少症和多关节病犬的血清胸苷激酶1、犬C反应蛋白、触珠蛋白和维生素D浓度

Serum Thymidine Kinase 1, Canine-C-Reactive Protein, Haptoglobin, and Vitamin D Concentrations in Dogs with Immune-Mediated Hemolytic Anemia, Thrombocytopenia, and Polyarthropathy.

作者信息

Grobman M, Outi H, Rindt H, Reinero C

机构信息

Department of Veterinary Medicine and Surgery, University of Missouri College of Veterinary Medicine, Columbia, MO.

Centro Veterinário Oswaldo Cruz, São José dos Campos, Brazil.

出版信息

J Vet Intern Med. 2017 Sep;31(5):1430-1440. doi: 10.1111/jvim.14787. Epub 2017 Aug 14.

Abstract

BACKGROUND

Relapses of immune-mediated hemolytic anemia (IMHA), thrombocytopenia (ITP), or polyarthropathy (IMPA) occur despite normal hematologic and cytologic parameters. Thymidine kinase 1 (TK1), canine C-reactive protein (c-CRP), haptoglobin (HPT), and 25-Hydroxyvitamin-D (25(OH)D) might be adjunct to current monitoring strategies.

HYPOTHESIS/OBJECTIVES: Compare serum concentrations of TK1, c-CRP, HPT, and 25(OH)D in dogs with well- and poorly controlled primary IMHA, ITP, or IMPA.

ANIMALS

Thirty-eight client-owned dogs.

METHODS

Prospective descriptive study. Dogs diagnosed with IMHA, ITP, or IMPA had serum biomarker concentrations measured commercially. Disease control was assessed by hematocrit/PCV and reticulocyte count, platelet count, and synovial fluid cytology for IMHA, ITP, and IMPA, respectively. Statistical analysis performed by Mann-Whitney rank-sum tests and receiver operating characteristic curves.

RESULTS

TK1 and c-CRP, but not HPT significantly decreased with well- versus poorly controlled IMHA (P = 0.047, P = 0.028, P = 0.37). C-CRP, but not TK or HPT was significantly lower with well- versus poorly controlled IMPA (P = 0.05, P = 0.28, P = 0.84). Sensitivity and specificity of TK and c-CRP (simultaneously) for detecting dogs with poorly controlled IMHA were 88 and 100%, respectively. Sensitivity and specificity of c-CRP for detecting poorly controlled dogs with IMPA were 13 and 100%, respectively. 92% of dogs were vitamin D insufficient (<100 ng/mL) regardless of disease control.

CONCLUSIONS AND CLINICAL IMPORTANCE

Combining TK1 and c-CRP might act markers of disease control in dogs with IMHA. Canine-CRP cannot be recommended as an independent marker of disease control in IMPA. 25(OH)D insufficiency in immune-mediated disorders might benefit from further study to determine if supplementation could improve therapeutic response or reduce disease risk.

摘要

背景

尽管血液学和细胞学参数正常,但免疫介导的溶血性贫血(IMHA)、血小板减少症(ITP)或多关节病(IMPA)仍会复发。胸苷激酶1(TK1)、犬C反应蛋白(c-CRP)、触珠蛋白(HPT)和25-羟基维生素D(25(OH)D)可能是当前监测策略的辅助手段。

假设/目的:比较原发性IMHA、ITP或IMPA控制良好和控制不佳的犬血清中TK1、c-CRP、HPT和25(OH)D的浓度。

动物

38只客户拥有的犬。

方法

前瞻性描述性研究。对诊断为IMHA、ITP或IMPA的犬进行商业化的血清生物标志物浓度检测。分别通过血细胞比容/红细胞压积和网织红细胞计数、血小板计数以及IMHA、ITP和IMPA的滑液细胞学检查来评估疾病控制情况。采用曼-惠特尼秩和检验和受试者工作特征曲线进行统计分析。

结果

与IMHA控制不佳相比,控制良好时TK1和c-CRP显著降低(P = 0.047,P = 0.028,P = 0.37)。与IMPA控制不佳相比,控制良好时c-CRP显著降低,但TK或HPT无显著差异(P = 0.05,P = 0.28,P = 0.84)。TK和c-CRP(同时)检测IMHA控制不佳犬的敏感性和特异性分别为88%和100%。c-CRP检测IMPA控制不佳犬的敏感性和特异性分别为13%和100%。无论疾病控制情况如何,92%的犬维生素D不足(<100 ng/mL)。

结论及临床意义

联合检测TK1和c-CRP可能作为IMHA犬疾病控制的标志物。不建议将犬C反应蛋白作为IMPA疾病控制的独立标志物。免疫介导疾病中25(OH)D不足可能需要进一步研究,以确定补充维生素D是否能改善治疗反应或降低疾病风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0837/5598893/6d8696e0d62c/JVIM-31-1430-g001.jpg

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