Small Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom.
J Vet Intern Med. 2022 Jan;36(1):86-96. doi: 10.1111/jvim.16322. Epub 2021 Dec 3.
Thromboembolic disease is a major cause of mortality in dogs with immune-mediated hemolytic anemia (IMHA). At present, no reliable biomarkers of individual patient thrombotic risk are available. In human medicine, increased urinary thromboxane concentrations have utility as markers of prothrombotic tendency in various situations.
HYPOTHESIS/OBJECTIVES: First, to determine if urinary 11-dehydrothromboxane B (u11-dTXB) concentrations are increased in dogs with primary IMHA compared to normal dogs; second, to assess whether u11-dTXB concentration is associated with survival, known prognostic indicators, or frequency of thrombosis in dogs with IMHA.
Twenty client-owned dogs diagnosed with primary IMHA and 17 healthy dogs volunteered by hospital staff.
Prospective case-control study. A previously validated ELISA was used to measure urine 11-dTXB concentrations, which were normalized to urine creatinine concentration (u11-dTXB:Cr). Samples were obtained at presentation from patients with primary IMHA. Standard clincopathological data at baseline and survival data were collected. Urinary 11-dTXB:Cr was compared between outcome subgroups, and correlated with known markers of disease severity.
Baseline u11-dTXB:Cr was significantly higher in dogs with IMHA than in healthy dogs (median, 3.75; range, 0.83-25.36 vs 0.65; 0.24-2.57; P = .003) but did not differ between dogs with IMHA that survived and did not survive to 30 days after presentation, nor between dogs with and without clinical suspicion of thrombotic disease.
Urinary 11-dTXB:Cr is increased in dogs with IMHA compared to healthy controls, consistent with a prothrombotic state. However, in this IMHA population u11-dTXB:Cr was not associated with survival or suspected thrombosis.
血栓栓塞性疾病是犬免疫介导性溶血性贫血(IMHA)患者死亡的主要原因。目前,尚无针对个体患者血栓形成风险的可靠生物标志物。在人类医学中,尿液中血栓素浓度的增加可作为各种情况下促血栓倾向的标志物。
假说/目的:首先,确定原发性 IMHA 犬的尿液 11-脱氢血栓烷 B(u11-dTXB)浓度是否高于正常犬;其次,评估 u11-dTXB 浓度与 IMHA 犬的生存、已知预后指标或血栓形成频率是否相关。
20 只经临床诊断为原发性 IMHA 的患犬和 17 只由医院工作人员自愿提供的健康犬。
前瞻性病例对照研究。使用已验证的 ELISA 测定尿液 11-dTXB 浓度,并将其标准化为尿液肌酐浓度(u11-dTXB:Cr)。从原发性 IMHA 患者就诊时采集样本。收集基线标准临床病理数据和生存数据。比较不同结局亚组的 u11-dTXB:Cr,并与疾病严重程度的已知标志物相关。
IMHA 犬的基线 u11-dTXB:Cr 明显高于健康犬(中位数 3.75;范围 0.83-25.36 与 0.65;0.24-2.57;P =.003),但在就诊后 30 天内存活和未存活的 IMHA 犬之间,以及有和无临床血栓形成怀疑的 IMHA 犬之间没有差异。
与健康对照组相比,IMHA 犬的 u11-dTXB:Cr 升高,提示存在促血栓形成状态。然而,在这个 IMHA 人群中,u11-dTXB:Cr 与生存或疑似血栓形成无关。