Biochemical and functional characterization of lymphocytes from a horse with lymphosarcoma and IgM deficiency

Immunodeficiency disorders in horses

Immunodeficiencies are characterized as primary (genetic) or secondary (acquired). Primary immunodeficiencies are relatively uncommon; however, clinically, they present a significant challenge to the practitioner, especially if the underlying disorder goes unrecognized. Secondary immunodeficiencies may present at any age, but failure of passive transfer in neonatal foals is most commonly encountered. This article provides a general overview of clinical signs and diagnosis of primary and secondary immunodeficiencies currently recognized in horses.

Immunologic Disorders in Neonatal Foals

Foals live in an environment heavily populated by bacteria, many of which are capable of causing disease. Development of infection,however, is the exception rather than the rule. The ability of the foal to prevent infection by most pathogens is the result of a sophisticated set of defense mechanisms. These defense mechanisms can be divided into adaptive and innate immunity. Innate immunity encompasses defense mechanisms that pre-exist or are rapidly induced within hours of exposure to a pathogen. Conversely, adaptive or acquired immunity represents host defenses mediated by T and B lymphocytes, each expressing a highly specific antigen receptor and exhibiting memory during a second encounter with a given antigen. Immunologic disorders are relatively common in foals compared with their occurrence in adult horses. This article summarizes the current understanding of the equine fetal and neonatal immune system and reviews common immunodeficiency disorders as well as disorders resulting from allogenic incompatibilities.

Serum IgM concentrations in normal, fit horses and horses with lymphoma or other medical conditions

The purposes of this study were to (1) prospectively establish serum IgM and IgG concentrations in normal, fit, adult horses over time and (2) determine the accuracy of serum IgM concentrations for diagnosing lymphoma. Serial IgM and IgG concentrations were measured with a radial immunodiffusion assay in 25 regularly exercised horses at 6-week intervals. Horses had serum IgM concentrations ranging from 50 to 242 mg/dL over 5 months, with 20% of horses having IgM < or = 60 mg/dL. The normal range for IgM in fit horses should be considered 103 +/- 40 mg/dL and a cut-point for an IgM deficiency, < or = 23 mg/dL. IgG concentrations ranged from 1,372 to 3,032 mg/dL. Retrospectively, medical records of adult horses (n = 103) admitted to the Cornell University Hospital for Animals for which serum IgM was measured were examined. Horses were categorized as "lymphoma negative" (n = 34) or "lymphoma positive" (n = 18). The sensitivity and specificity of a serum IgM concentration (< or = 60 mg/dL) for detecting equine lymphoma was 50 and 35%, respectively. At the new cut-point (< or = 23 mg/dL), the sensitivity was low at 28% and the specificity improved to 88%. The negative predictive values at various population prevalences indicate that a horse with a high serum IgM (> 23 mg/dL) is unlikely to have lymphoma, whereas the positive predictive value (70%) does not allow for reliable determination of lymphoma in a horse with serum IgM < or = 23 mg/dL. Therefore, serum IgM concentrations should not be used as a screening test for equine lymphoma.

Secondary immunodeficiencies of horses

FPT of immunoglobulin in foals is the commonest form of acquired immunodeficiency in horses. FPT predisposes foals to bacterial infections and septicemia and easily is preventable and treatable if breeding farms and veterinarians are attentive to optimum foaling management practices. Other forms of acquired immunodeficiencies are uncommon in horses, although immune function may be transiently suppressed by a wide variety of drugs, infections, or other conditions. As immunologic testing becomes more sophisticated and more readily available to equine practitioners, acquired immunodeficiencies are likely to be characterized more frequently in horses.

Lymphoproliferative and myeloproliferative disorders

Nomenclature regarding neoplasia of the hematopoietic and lymphoid tissues in the horse is confusing. This article will clarify terminology, and discuss the individual lymphoproliferative and myeloproliferative disorders recognized in the horse. Diagnostic techniques that are useful in cases in which hematopoietic or lymphoid tissue neoplasia are suspected include histochemical staining profiles, bone marrow aspiration, and bone marrow biopsy.

Acquired B lymphocyte deficiency and chronic enterocolitis in a 3-year-old quarter horse

This case report describes a 3-year-old American Quarter Horse with acquired immunodeficiency. Clinical signs included chronic diarrhea due to Salmonella typhimurium and bacterial pneumonia. Characterization of the immunodeficiency involved in vivo phytohemagglutinin (PHA) intradermal testing, in vitro lymphocyte proliferation in response to concanavalin A, immunofluorescence flow cytometry data on blood lymphocytes, serum protein electrophoresis and immunoglobulin (Ig) quantification. A diagnosis of B lymphocyte deficiency with resulting deficiencies in serum IgG, IgA and IgM and a concurrent decrease in T cell function was made based on these tests. Postmortem examination revealed no evidence of lymphosarcoma. This case represents a variation of young adult-onset B cell deficiency not previously described in the literature.

Immunodiagnostic assays

The immune system is a complex interactive network. Defects in its function can be characterized broadly as being the result of actual deficiencies in the network or misdirection of normal immunologic functions. The assays that are available to detect deficiencies in the immunologic network barely scrape the surface of the possibilities. These assays primarily evaluate humoral immune function, but undetected defects in innate and cellular immunity are sure to exist. Although assays of humoral immunity have allowed the characterization of a number of immunodeficiency syndromes in horses, closer evaluation of the equine immune system using newer assays described in this text, as well as future assays yet to be developed are sure to determine new syndromes. Assays of misdirected immunologic functions have been limited to detection of misdirected antibody responses, but the dependence of antibody production on help from T cells could reflect an underlying defect of cellular immunity. Similar to immunodeficiency syndromes, misdirected responses of the innate and adaptive arms of immunity are sure to occur but will only be detected by more diligent surveillance of diseased horses and application of new immunodiagnostic technologies.

Immunologic studies of a horse with lymphosarcoma

Immunological, clinical, and pathological investigations were conducted on a horse with lymphosarcoma. The immunological status was investigated by measuring the level of antibodies by single radial immunodiffusion test and the ability of lymphocytes to proliferate in response to mitogens. Multiple immunological abnormalities were noted in this horse. They were; (1) decreased IgM, IgG, and IgA levels in the serum despite hyperproteinemia; (2) increased in-vitro spontaneous lymphoproliferation which reflects augmented mitosis; (3) decreased lymphoproliferative response to T cell stimulants (e.g. Concanavalin-A (Con-A)) suggesting impaired T cell activation; (4) presence of immunosuppressive factors in serum as demonstrated by in-vitro lymphocyte culture systems. Clinical pathology findings revealed an unusual monoclonal alpha peak in the serum and morphologically abnormal lymphocytes distributed throughout the body. Serum fractionated by fast protein liquid chromatography (FPLC) revealed that the immunosuppressive factors were found in this abnormal alpha peak. The immunopathological findings in this horse are discussed.

Unusual selective immunoglobulin deficiency in an Arabian foal

A 10-month-old Arabian foal was evaluated for a suspected immunoglobulin (Ig) M deficiency. Decreased to nondetectable concentrations of IgM, IgA, and IgG (T), and a normal concentration of IgG, were present. Results of in vitro testing of the blood lymphocyte blastogenesis showed a weak response to the B-cell mitogen, lipopolysaccharide (LPS), but normal responses to T-cell mitogens. Results of postmortem examination showed synovitis of the left tibiotarsal and both scapulohumeral joints. Atrophy and edema of the lymph nodes and lymphocyte depletion in the thymus and spleen were seen. A subacute inflammatory infiltrate was observed in the kidney, synovium, liver, and brain. Etiologic agents were not identified. This case represents a previously unreported form of immunodeficiency disease in the horse.

T lymphocyte development in horses. I. Characterization of monoclonal antibodies identifying three stages of T lymphocyte differentiation

Six monoclonal antibodies reacting with equine T lymphocytes at different stages of maturation were selected from antibodies produced against lymphoid cell preparations. EqT12 and EqT13 antibodies identified subsets of cortical thymocytes with high terminal deoxynucleotidyltransferase (TdT) activity and no phytolectin responsiveness. EqT12+ thymocytes were scattered throughout the cortex while EqT13+ thymocytes were located in the subcapsular cortex. EqT12 bound to small numbers of bone marrow cells, splenocytes, and circulating lymphoid cells, but not to mature T lymphocytes. EqT13 bound to very small numbers of bone marrow cells but not to more mature lymphocytes. EqT6 and EqT7 reacted with a large population of cortical thymocytes with high TdT activity and no phytolectin responsiveness. EqT2 and EqT3 bound primarily to medullary thymocytes with low TdT activity. Eq2+ thymocytes responded to phytolectin stimulation while EqT3+ thymocytes did not. EqT2 and EqT3 bound to 33% and 91% of circulating T lymphocytes, respectively. The T lymphocytes bound by both antibodies included cells capable of suppressing a mixed lymphocyte reaction. Thus, EqT12 and EqT13 identify cells with the functional characteristics of prothymocytes. EqT6 and EqT7 identify resident cortical thymocytes, and EqT2 and EqT3 identify a subpopulation of mature T lymphocytes and all mature T lymphocytes, respectively.

Evaluation of foals for immune deficiency disorders

Currently recognized equine immune deficiency disorders include failure of passive colostral immunoglobulin transfer, combined immunodeficiency, selective IgM deficiency, transient hypogammaglobulinemia, and agammaglobulinemia. Additional equine immune deficiency disorders probably exist. Immune deficiency should be suspected in any horse experiencing persistent or recurrent infections that are not responsive to conventional therapy.