Equine Clinic, Freie Universitaet Berlin, Berlin, Germany.
Research Centre of Medical Technology and Biotechnology, Bad Langensalza, Germany.
Mediators Inflamm. 2021 Jan 5;2021:9501478. doi: 10.1155/2021/9501478. eCollection 2021.
The purpose of the study was to compare the results of sepsis scoring (clinical examination and clinical pathology) to the concentrations of matrix-metalloproteinases (MMPs) -2, -8, and -9; tissue-inhibitor of metalloproteinases (TIMPs) -1 and -2; and inflammatory chemokines interleukin (IL) 1 and tumor-necrosis-factor-alpha (TNF-) in plasma and peritoneal fluid of equine colic patients. A modified sepsis scoring including general condition, heart and respiratory rate, rectal temperature, mucous membranes, white blood cell count (WBC), and ionized calcium was applied in 47 horses presented with clinical signs of colic. Using this scoring system, horses were classified as negative ( = 32, ≤6/19 points), questionable ( = 9, 7-9/19 points), or positive ( = 6, ≥10/19 points) for sepsis. MMPs, TIMPs, IL-1, and TNF- concentrations were evaluated in plasma and peritoneal fluid using species-specific sandwich ELISA kits. In a linear discriminant analysis, all parameters of sepsis scoring apart from calcium separated well between sepsis severity groups ( < 0.05). MMP-9 was the only biomarker of high diagnostic value, while all others remained insignificant. A significant influence of overall sepsis scoring on MMP-9 was found for peritoneal fluid ( = 0.005) with a regression coefficient of 0.092, while no association was found for plasma ( = 0.085). Using a MMP-9 concentration of >113 ng/ml in the peritoneal fluid was found to be the ideal cutoff to identify positive sepsis scoring (≥10/19 points; sensitivity of 83.3% and specificity of 82.9%). In conclusion, MMP-9 was found to be a biomarker of high diagnostic value for sepsis and endotoxemia in equine colic. The evaluation of peritoneal fluid seems preferable in comparison to plasma. As abdominocentesis is commonly performed in the diagnostic work-up of equine colic, a pen-side assay would be useful and easy-to-perform diagnostic support in the decision for therapeutic intervention.
本研究旨在比较脓毒症评分（临床检查和临床病理学）与基质金属蛋白酶（MMPs）-2、-8 和 -9；组织金属蛋白酶抑制剂（TIMPs）-1 和 -2；以及白细胞介素（IL）1 和肿瘤坏死因子-α（TNF-α）在患有腹痛的马的血浆和腹腔液中的浓度。在 47 匹出现腹痛临床症状的马中应用了改良的脓毒症评分，包括一般情况、心率和呼吸频率、直肠温度、黏膜、白细胞计数（WBC）和离子钙。使用该评分系统，马被分为阴性（=32，≤6/19 分）、可疑（=9，7-9/19 分）或阳性（=6，≥10/19 分）。使用种特异性夹心 ELISA 试剂盒评估 MMPs、TIMPs、IL-1 和 TNF-α在血浆和腹腔液中的浓度。在线性判别分析中，除钙以外的所有脓毒症评分参数在脓毒症严重程度组之间分离良好（<0.05）。MMP-9 是唯一具有高诊断价值的生物标志物，而其他所有标志物均无意义。在腹腔液中，整体脓毒症评分对 MMP-9 有显著影响（=0.005），回归系数为 0.092，而在血浆中无关联（=0.085）。发现腹腔液中 MMP-9 浓度>113ng/ml 是识别阳性脓毒症评分（≥10/19 分；敏感性为 83.3%，特异性为 82.9%）的理想截断值。总之，MMP-9 被发现是马腹痛脓毒症和内毒素血症的高诊断价值生物标志物。与血浆相比，评估腹腔液似乎更可取。由于腹腔穿刺术在马腹痛的诊断中通常是常规进行的，因此床边检测将是一种有用且易于操作的诊断支持，有助于决定是否进行治疗干预。
