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Sponseller B, Evans T. Plants Causing Toxic Myopathies. Vet Clin North Am Equine Pract 2024; 40:45-59. [PMID: 38151404 DOI: 10.1016/j.cveq.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023] Open
Abstract
Boxelder and sycamore maple contain hypoglycin A (HGA), the toxic metabolite of which, MCPA-CoA, inhibits fatty acid β-oxidation, causing seasonal pasture myopathy (SPM) or atypical myopathy (AM), respectively. White snakeroot and rayless goldenrod contain multiple benzofuran ketones (BFKs). The identity/toxicity of BFKs appear variable, possibly involving interactions between toxins/toxic metabolites, but ultimately inhibit cellular energy metabolism. Unthrifty horses grazing sparse pastures during the fall appear predisposed to these plant-associated, frequently fatal, toxic myopathies. Toxidromes are characterized by varying degrees of rhabdomyolysis and cardiac myonecrosis, with plant toxins remaining toxic in hay and being excreted in milk.
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Affiliation(s)
- Beatrice Sponseller
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1809 South Riverside Drive, Ames, IA 50011, USA.
| | - Tim Evans
- Department of Biomedical Sciences, College of Veterinary Medicine and MU Extension, University of Missouri, W226 Veterinary Medicine Building, 1520 East Rollins Street, Columbia, MO 65211, USA
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Jahn P, Dobešová D, Brumarová R, Tóthová K, Kopecká A, Friedecký D. Dynamics of acylcarnitines, hypoglycin A, méthylènecyclopropylglycine and their metabolites in a Kladruber stallion with atypical myopathy. Vet Q 2022; 42:183-191. [PMID: 36114619 PMCID: PMC9518284 DOI: 10.1080/01652176.2022.2126537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Equine atypical myopathy (AM also referred to as multiple acyl-CoA dehydrogenases deficiency [MADD]) is thought to be caused by toxins metabolized from hypoglycin A (HGA) and méthylènecyclopropylglycine (MCPrG). HGA is contained in the seeds and seedlings of the sycamore tree (Acer pseudoplatanus); MCPrG has so far only been confirmed in seeds. Among other things, these substances can disrupt the fatty acids β-oxidation pathway with the subsequent accumulation of certain acylcarnitines. The tentative diagnosis is based on anamnesis and clinical signs and can be verified by the detection of elevated creatine kinase activity, specific profile of acylcarnitines and the presence of HGA, MCPrG conjugates and/or their metabolites in peripheral blood and/or urine. Dry blood spots were collected for 15 days from a 3.5-year-old stallion which had been affected by AM and, as a control group, from twelve healthy horses. Two mass spectrometry methods were used for the analysis of 31 acylcarnitines, carnitine, HGA, MCPrG and their metabolites. HGA and six increased acylcarnitines were detected in the patient’s blood throughout the monitoring period. Nine acylcarnitines were strongly correlated with HGA. Multivariate statistical analysis showed a clear separation of samples from the AM horse, where the metabolic profile tended to normalization in the later days after intoxication. Due to the longer persistence in the blood, the detection of HGA and elevated acylcarnitines profile appear to be an appropriate tool to confirm the diagnosis of AM, compared to metabolic products of HGA and MCPrG even in advanced cases.
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Affiliation(s)
- Petr Jahn
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Dana Dobešová
- Laboratory for Inherited Metabolic Disorders, Department of Clinical Biochemistry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
| | - Radana Brumarová
- Laboratory for Inherited Metabolic Disorders, Department of Clinical Biochemistry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
| | - Katarína Tóthová
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Andrea Kopecká
- Equine Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - David Friedecký
- Laboratory for Inherited Metabolic Disorders, Department of Clinical Biochemistry, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Czech Republic
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3
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Differences in the serum metabolome profile of dairy cows according to the BHB concentration revealed by proton nuclear magnetic resonance spectroscopy ( 1H-NMR). Sci Rep 2022; 12:2525. [PMID: 35169190 PMCID: PMC8847571 DOI: 10.1038/s41598-022-06507-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 02/01/2022] [Indexed: 12/15/2022] Open
Abstract
The mobilization of body reserves during the transition from pregnancy to lactation might predispose dairy cows to develop metabolic disorders such as subclinical ketosis or hyperketonemia. These conditions are not easily identifiable and are frequently related to other diseases that cause economic loss. The aim of this study was to evaluate the serum metabolome differences according to the β-hydroxybutyrate (BHB) concentration. Forty-nine Holstein Friesian dairy cows were enrolled between 15 and 30 days in milk. According to their serum BHB concentration, the animals were divided into three groups: Group 0 (G0; 12 healthy animals; BHB ≤ 0.50 mmol/L); Group 1 (G1; 19 healthy animals; 0.51 ≤ BHB < 1.0 mmol/L); and Group 2 (G2; 18 hyperketonemic animals; BHB ≥ 1.0 mmol/L). Animal data and biochemical parameters were examined with one-way ANOVA, and metabolite significant differences were examined by t-tests. Fifty-seven metabolites were identified in the serum samples. Thirteen metabolites showed significant effects and seemed to be related to the mobilization of body reserves, lipids, amino acid and carbohydrate metabolism, and ruminal fermentation.
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Diagnosis of atypical myopathy based on organic acid and acylcarnitine profiles and evolution of biomarkers in surviving horses. Mol Genet Metab Rep 2021; 29:100827. [PMID: 34900597 PMCID: PMC8639802 DOI: 10.1016/j.ymgmr.2021.100827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background Atypical myopathy (AM), an acquired multiple acyl-CoA dehydrogenase deficiency (MADD) in horses, induce changes in mitochondrial metabolism. Only few veterinary laboratories offer diagnostic testing for this disease. Inborn and acquired MADD exist in humans, therefore determination of organic acids (OA) in urine and acylcarnitines (AC) in blood by assays available in medical laboratories can serve as AM diagnostics. The evolution of OA and AC profiles in surviving horses is unreported. Methods AC profiles using electrospray ionization tandem mass spectrometry (ESI-MS/MS) and OA in urine using gas chromatography mass spectrometry (GC–MS) were determined in dried blot spots (DBS, n = 7) and urine samples (n = 5) of horses with AM (n = 7) at disease presentation and in longitudinal samples from 3/4 survivors and compared to DBS (n = 16) and urine samples (n = 7) from control horses using the Wilcoxon test. Results All short- (C2-C5) and medium-chain (C6-C12) AC in blood differed significantly (p < 0.008) between horses with AM and controls, except for C5:1 (p = 0.45) and C5OH + C4DC (p = 0.06). In AM survivors the AC concentrations decreased over time but were still partially elevated after 7 days. 14/62 (23%) of OA differed significantly between horses with AM and control horses. Concentrations of ethylmalonic acid, 2-hydroxyglutaric acid and the acylglycines (butyryl-, valeryl-, and hexanoylglycine) were highly elevated in the urine of all horses with AM at the day of disease presentation. In AM survivors, concentrations of those metabolites were initially lower and decreased during remission to approach normalization after 7 days. Conclusion OA and AC profiling by specialized human medical laboratories was used to diagnose AM in horses. Elevation of specific metabolites were still evident several days after disease presentation, allowing diagnosis via analysis of samples from convalescent animals. Human medical laboratories can be used to diagnose atypical myopathy in horses. Diagnosis can be achieved by organic acid and acylcarnitine profiling. Diagnosis can also be achieved in convalescent horses. Specific metabolites are still evident several days after clinical signs start. Some metabolites differentiated between survivors and non-survivors.
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5
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Sander J, Terhardt M, Sander S, Aboling S, Janzen N. A new method for quantifying causative and diagnostic markers of methylenecyclopropylglycine poisoning. Toxicol Rep 2019; 6:803-808. [PMID: 31440457 PMCID: PMC6699453 DOI: 10.1016/j.toxrep.2019.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/29/2019] [Accepted: 08/02/2019] [Indexed: 11/29/2022] Open
Abstract
Quantification of methylenecyclopropylglycine by tandem mass spectrometry. Combined measurement of acyl compounds and toxins of Sapindaceae. Rapid diagnosis of soapberry poisoning by serum and urine analysis.
Background Up to now quantification of hypoglycin A in serum and urine in the range of nmols to μmols per liter plus the measurement of accumulated acyl conjugates have been used for the diagnosis of poisoning by fruits or seeds ofSapindaceae in humans and animals. A second poison, methylenecyclopropylglycine, however, is known to occur in this material. The objective of our study was to develop and evaluate a method for the quantification of this compound suitable for test materials obtained from animals and man. Method Methylenecyclopropylglycine was extracted from serum and urine of a volunteer by a methanolic solution containing labeled methylenecyclopropylglycine as internal standard. UPLC-MS/MS analysis was performed after butylation. Results Lower limits of detection and quantification were found at 0.5 and 2.5 nmol/L respectively in both urine and serum for each of two isomers, linearity of results (r2 > 0.998) was demonstrated for the range of 0.5–500 nmol/L in urine and serum. The method was applied to urine and serum of horses poisoned by Acer seeds, methylenecyclopropylglycine was found in addition to hypoglycin A. Methylenecyclopropylformyl glycine, a metabolite of methylenecyclopropylglycine, however, was present in much higher concentrations than methylenecyclopropylglycine in all but one samples. Conclusions Quantification of methylenecyclopropylglycine can be successfully integrated into our established analytical procedure used for clinical diagnosis of Sapindaceae poisoning. The extended method will improve disease evaluation in humans and animals.
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Affiliation(s)
| | | | | | - Sabine Aboling
- Institute for Animal Nutrition, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Nils Janzen
- Screening-Labor Hannover, Ronnenberg, Germany.,Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
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Hunt H, Fraser K, Cave NJ, Gartrell BD, Petersen J, Roe WD. Untargeted metabolic profiling of dogs with a suspected toxic mitochondrial myopathy using liquid chromatography-mass spectrometry. Toxicon 2019; 166:46-55. [PMID: 31102596 DOI: 10.1016/j.toxicon.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/22/2019] [Accepted: 05/11/2019] [Indexed: 10/26/2022]
Abstract
'Go Slow myopathy' (GSM) is a suspected toxic myopathy in dogs that primarily occurs in the North Island of New Zealand, and affected dogs usually have a history of consuming meat, offal or bones from wild pigs (including previously frozen and/or cooked meat). Previous epidemiological and pathological studies on GSM have demonstrated that changes in mitochondrial structure and function are most likely caused by an environmental toxin that dogs are exposed to through the ingestion of wild pig. The disease has clinical, histological and biochemical similarities to poisoning in people and animals from the plant Ageratina altissima (white snakeroot). Aqueous and lipid extracts were prepared from liver samples of 24 clinically normal dogs and 15 dogs with GSM for untargeted liquid chromatography-mass spectrometry. Group-wise comparisons of mass spectral data revealed 38 features that were significantly different (FDR<0.05) between normal dogs and those with GSM in aqueous extracts, and 316 significantly different features in lipid extracts. No definitive cause of the myopathy was identified, but alkaloids derived from several plant species were among the possible identities of features that were more abundant in liver samples from affected dogs compared to normal dogs. Mass spectral data also revealed that dogs with GSM have reduced hepatic phospholipid and sphingolipid concentrations relative to normal dogs. In addition, affected dogs had changes in the abundance of kynurenic acid, various dicarboxylic acids and N-acetylated branch chain amino acids, suggestive of mitochondrial dysfunction.
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Affiliation(s)
- H Hunt
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - K Fraser
- Food Nutrition and Health Team, Food and Bio-Based Products Group, AgResearch Grasslands Research Centre, Palmerston North, New Zealand
| | - N J Cave
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - B D Gartrell
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - J Petersen
- Norvet Services Ltd., Okaihau, New Zealand
| | - W D Roe
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Detection of MCPG metabolites in horses with atypical myopathy. PLoS One 2019; 14:e0211698. [PMID: 30721263 PMCID: PMC6363182 DOI: 10.1371/journal.pone.0211698] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/19/2019] [Indexed: 12/05/2022] Open
Abstract
Atypical myopathy (AM) in horses is caused by ingestion of seeds of the Acer species (Sapindaceae family). Methylenecyclopropylacetyl-CoA (MCPA-CoA), derived from hypoglycin A (HGA), is currently the only active toxin in Acer pseudoplatanus or Acer negundo seeds related to AM outbreaks. However, seeds or arils of various Sapindaceae (e.g., ackee, lychee, mamoncillo, longan fruit) also contain methylenecyclopropylglycine (MCPG), which is a structural analogue of HGA that can cause hypoglycaemic encephalopathy in humans. The active poison formed from MCPG is methylenecyclopropylformyl-CoA (MCPF-CoA). MCPF-CoA and MCPA-CoA strongly inhibit enzymes that participate in β-oxidation and energy production from fat. The aim of our study was to investigate if MCPG is involved in Acer seed poisoning in horses. MCPG, as well as glycine and carnitine conjugates (MCPF-glycine, MCPF-carnitine), were quantified using high-performance liquid chromatography-tandem mass spectrometry of serum and urine from horses that had ingested Acer pseudoplatanus seeds and developed typical AM symptoms. The results were compared to those of healthy control horses. For comparison, HGA and its glycine and carnitine derivatives were also measured. Additionally, to assess the degree of enzyme inhibition of β-oxidation, several acyl glycines and acyl carnitines were included in the analysis. In addition to HGA and the specific toxic metabolites (MCPA-carnitine and MCPA-glycine), MCPG, MCPF-glycine and MCPF-carnitine were detected in the serum and urine of affected horses. Strong inhibition of β-oxidation was demonstrated by elevated concentrations of all acyl glycines and carnitines, but the highest correlations were observed between MCPF-carnitine and isobutyryl-carnitine (r = 0.93) as well as between MCPA- (and MCPF-) glycine and valeryl-glycine with r = 0.96 (and r = 0.87). As shown here, for biochemical analysis of atypical myopathy of horses, it is necessary to take MCPG and the corresponding metabolites into consideration.
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Karlíková R, Široká J, Mech M, Friedecký D, Janečková H, Mádrová L, Hrdinová F, Drábková Z, Dobešová O, Adam T, Jahn P. Newborn foal with atypical myopathy. J Vet Intern Med 2018; 32:1768-1772. [PMID: 30216546 PMCID: PMC6189353 DOI: 10.1111/jvim.15236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/18/2018] [Accepted: 05/09/2018] [Indexed: 12/20/2022] Open
Abstract
The case of atypical myopathy (AM) in newborn Haflinger foal with clinical signs of depression and weakness appearing 6 hours after birth resulting in recumbency 12 hours after birth is described. The foal's dam was diagnosed with AM in the 6th month of gestation based on clinical signs of a myopathy, elevated serum activity of creatine kinase, metabolomic analysis and the presence of methylenecyclopropyl acetyl carnitine (MCPA‐carnitine) in the blood. At the time of delivery, the mare was grazing on a pasture near sycamore trees but was free of clinical signs of AM. Metabolomic analysis of the foal's blood revealed increased concentrations of acylcarnitines and MCPA‐carnitine consistent with metabolic profiles of blood from AM affected horses. Two theories could explain this observation (a) hypoglycin A or its metabolites accumulated in the mare's placenta with consequent transfer to fetus or (b) these compounds were secreted into mare's milk.
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Affiliation(s)
- Radana Karlíková
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic
| | - Jitka Široká
- Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic.,Faculty of Science, Laboratory of Growth Regulators, Centre of the Region Haná for Biotechnological and Agricultural Research, Palacký University and Institute of Experimental Botany ASCR, Olomouc, Czech Republic
| | - Marek Mech
- Private Veterinary Practice, Jistebník, Czech Republic
| | - David Friedecký
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic.,Laboratory for Inherited Metabolic Disorders, University Hospital, and Palacký University, Olomouc, Czech Republic
| | - Hana Janečková
- Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic.,Laboratory for Inherited Metabolic Disorders, University Hospital, and Palacký University, Olomouc, Czech Republic
| | - Lucie Mádrová
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic
| | - Františka Hrdinová
- Faculty of Veterinary Medicine, Equine Clinic, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Zuzana Drábková
- Faculty of Veterinary Medicine, Equine Clinic, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Olga Dobešová
- Faculty of Veterinary Medicine, Equine Clinic, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Tomáš Adam
- Department of Clinical Biochemistry, University Hospital Olomouc, Olomouc, Czech Republic.,Faculty of Medicine and Dentistry, Palacký University, Institute of Molecular and Translational Medicine, Olomouc, Czech Republic.,Laboratory for Inherited Metabolic Disorders, University Hospital, and Palacký University, Olomouc, Czech Republic
| | - Petr Jahn
- Faculty of Veterinary Medicine, Equine Clinic, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
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Pinn TL, Divers TJ, Southard T, De Bernardis NP, Wakshlag JJ, Valberg S. Persistent hypoglycemia associated with lipid storage myopathy in a paint foal. J Vet Intern Med 2018; 32:1442-1446. [PMID: 29957835 PMCID: PMC6060329 DOI: 10.1111/jvim.15218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/15/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022] Open
Abstract
A 12‐hours‐old Paint filly was examined because of weakness and dull mentation after birth. Despite IV administered dextrose, the foal remained persistently hypoglycemic with increase in serum activity of muscle and liver enzymes. A postmortem diagnosis of lipid myopathy most similar to multiple acyl‐CoA dehydrogenase deficiency (MADD) was confirmed by findings of myofiber lipid accumulation, elevated urine organic acids, and serum free acylcarnitines with respect to control foals. This report details a case of equine neonatal lipid storage myopathy with many biochemical characteristics of MADD. Lipid storage myopathies should be included as a differential diagnosis in foals with persistent weakness and hypoglycemia.
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Affiliation(s)
- Toby L Pinn
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Thomas J Divers
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Teresa Southard
- Department of Biomedical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | | | - Joe J Wakshlag
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York
| | - Stephanie Valberg
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan
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Dunkel B, Ryan A, Haggett E, Knowles EJ. Atypical myopathy in the South‐East of England: Clinicopathological data and outcome in hospitalised horses. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12895] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- B. Dunkel
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - A. Ryan
- Department of Clinical Science and Services The Royal Veterinary College North Mymms Hertfordshire UK
| | - E. Haggett
- Rossdales Equine Hospital and Diagnostic Centre Newmarket Suffolk UK
| | - E. J. Knowles
- Bell Equine Veterinary Clinic Mereworth Maidstone Kent UK
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11
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González-Medina S, Ireland JL, Piercy RJ, Newton JR, Votion DM. Equine atypical myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival. Equine Vet J 2017; 49:746-752. [PMID: 28445006 DOI: 10.1111/evj.12694] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 04/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Equine atypical myopathy (AM) is a toxic rhabdomyolysis associated with ingestion of hypoglycin A, derived typically in Europe, from Acer pseudoplatanus tree. Despite the wide distribution of this tree species in the UK, the number of cases reported annually varies, and there has been an apparent increase in prevalence in recent years. Although AM was first recognised in the UK, epidemiological studies have never been conducted focused solely on this country. OBJECTIVES To describe the spatiotemporal distribution, presentation, treatment and outcome of AM cases reported in the UK. STUDY DESIGN Retrospective case series. METHODS British AM cases reported to the atypical myopathy alert website, between 2011 and 2015 were included (n = 224). Data were obtained via standardised epidemiological questionnaires from owners and veterinarians. Factors associated with survival were assessed using logistic regression. RESULTS Most cases reported were from England (87.9%). Survival was 38.6% (n = 73/189). Clinical factors associated with reduced odds of survival included, hypothermia (odds ratio [OR] 0.18; 95% confidence interval [CI] 0.06-0.57; P = 0.01), bladder distension (OR 0.11; CI 0.02-0.59; P = 0.01), tachycardia (OR 0.97; CI 0.94-0.99; P = 0.04) and serum creatine kinase activity >100,000 IU/L (OR 0.17; CI 0.04-0.68; P = 0.01) in the univariable analysis as well as recumbency. The latter was the only sign retained in multivariable analysis (OR = 0.19; CI 0.06-0.62; P = 0.006). Administration of vitamins during the disease was associated with survival (OR 3.75; CI 1.21-11.57; P = 0.02). MAIN LIMITATIONS Reporting cases to the Atypical Myopathy Alert Group is voluntary; therefore, under-reporting will result in underestimation of AM cases; furthermore, direct owner-reporting could have introduced misdiagnosis bias. CONCLUSION Some areas of the UK reported AM cases more commonly. Clinical signs such as recumbency, rectal temperature, distended bladder and serum creatine kinase activity might be useful prognostic indicators though should be considered in the context of the clinical picture. Treatment with vitamins increases odds of survival.
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Affiliation(s)
- S González-Medina
- Comparative Neuromuscular Diseases Laboratory, The Royal Veterinary College, London, UK.,Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - J L Ireland
- Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - R J Piercy
- Comparative Neuromuscular Diseases Laboratory, The Royal Veterinary College, London, UK
| | - J R Newton
- Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK
| | - D M Votion
- Equine Medicine Department, Pole Equine, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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12
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Naviaux RK, Naviaux JC, Li K, Bright AT, Alaynick WA, Wang L, Baxter A, Nathan N, Anderson W, Gordon E. Metabolic features of chronic fatigue syndrome. Proc Natl Acad Sci U S A 2016; 113:E5472-80. [PMID: 27573827 PMCID: PMC5027464 DOI: 10.1073/pnas.1607571113] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
More than 2 million people in the United States have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We performed targeted, broad-spectrum metabolomics to gain insights into the biology of CFS. We studied a total of 84 subjects using these methods. Forty-five subjects (n = 22 men and 23 women) met diagnostic criteria for ME/CFS by Institute of Medicine, Canadian, and Fukuda criteria. Thirty-nine subjects (n = 18 men and 21 women) were age- and sex-matched normal controls. Males with CFS were 53 (±2.8) y old (mean ± SEM; range, 21-67 y). Females were 52 (±2.5) y old (range, 20-67 y). The Karnofsky performance scores were 62 (±3.2) for males and 54 (±3.3) for females. We targeted 612 metabolites in plasma from 63 biochemical pathways by hydrophilic interaction liquid chromatography, electrospray ionization, and tandem mass spectrometry in a single-injection method. Patients with CFS showed abnormalities in 20 metabolic pathways. Eighty percent of the diagnostic metabolites were decreased, consistent with a hypometabolic syndrome. Pathway abnormalities included sphingolipid, phospholipid, purine, cholesterol, microbiome, pyrroline-5-carboxylate, riboflavin, branch chain amino acid, peroxisomal, and mitochondrial metabolism. Area under the receiver operator characteristic curve analysis showed diagnostic accuracies of 94% [95% confidence interval (CI), 84-100%] in males using eight metabolites and 96% (95% CI, 86-100%) in females using 13 metabolites. Our data show that despite the heterogeneity of factors leading to CFS, the cellular metabolic response in patients was homogeneous, statistically robust, and chemically similar to the evolutionarily conserved persistence response to environmental stress known as dauer.
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Affiliation(s)
- Robert K Naviaux
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Pediatrics, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Pathology, University of California, San Diego School of Medicine, San Diego, CA 92103-8467;
| | - Jane C Naviaux
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Neurosciences, University of California, San Diego School of Medicine, San Diego, CA 92103-8467
| | - Kefeng Li
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467
| | - A Taylor Bright
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467
| | - William A Alaynick
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467
| | - Lin Wang
- The Mitochondrial and Metabolic Disease Center, University of California, San Diego School of Medicine, San Diego, CA 92103-8467; Department of Medicine, University of California, San Diego School of Medicine, San Diego, CA 92103-8467
| | - Asha Baxter
- Gordon Medical Associates, Santa Rosa, CA 95403
| | - Neil Nathan
- Gordon Medical Associates, Santa Rosa, CA 95403
| | | | - Eric Gordon
- Gordon Medical Associates, Santa Rosa, CA 95403
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Karlíková R, Široká J, Jahn P, Friedecký D, Gardlo A, Janečková H, Hrdinová F, Drábková Z, Adam T. Equine atypical myopathy: A metabolic study. Vet J 2016; 216:125-32. [PMID: 27687939 DOI: 10.1016/j.tvjl.2016.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/25/2016] [Accepted: 07/27/2016] [Indexed: 10/21/2022]
Abstract
Atypical myopathy (AM) is a potentially fatal disease of grazing horses. It is reportedly caused by the ingestion of sycamore seeds containing toxic hypoglycin A. In order to study metabolic changes, serum and urine samples from nine horses with atypical myopathy and 12 control samples from clinically healthy horses were collected and then analysed using a high-performance liquid chromatography coupled with tandem mass spectrometry; serum metabolic profiles as the disease progressed were also studied. Metabolic data were evaluated using unsupervised and supervised multivariate analyses. Significant differences were demonstrated in the concentrations of various glycine conjugates and acylcarnitines (C2-C26). Moreover, the concentrations of purine and pyrimidine metabolites, vitamins and their degradation products (riboflavin, trigonelline, pyridoxate, pantothenate), and selected organic and amino acids (aspartate, leucine, 2-oxoglutarate, etc.) were altered in horses with AM. These results represent a global view of altered metabolism in horses with atypical myopathy.
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Affiliation(s)
- R Karlíková
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic
| | - J Široká
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic.
| | - P Jahn
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - D Friedecký
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - A Gardlo
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Department of Mathematical Analysis and Applications of Mathematics, Palacký University, 17. listopadu 12, 771 46 Olomouc, Czech Republic
| | - H Janečková
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - F Hrdinová
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - Z Drábková
- Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Palackého tř. 1/3, 612 42 Brno, Czech Republic
| | - T Adam
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 5, 779 00 Olomouc, Czech Republic; Laboratory for Inherited Metabolic Disorders, University Hospital and Faculty of Medicine and Dentistry, Palacký University, I.P. Pavlova 6, 775 20 Olomouc, Czech Republic
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Bauquier J, Stent A, Gibney J, Jerrett I, White J, Tennent-Brown B, Pearce A, Pitt J. Evidence for marsh mallow (Malva parviflora
) toxicosis causing myocardial disease and myopathy in four horses. Equine Vet J 2016; 49:307-313. [DOI: 10.1111/evj.12604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Affiliation(s)
- J. Bauquier
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Stent
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - J. Gibney
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - I. Jerrett
- Victorian Department of Environment and Primary Industries; Bundoora Victoria Australia
| | - J. White
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Parkville Victoria Australia
| | - B. Tennent-Brown
- Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Victoria Australia
| | - A. Pearce
- Golden Plains Equine; Bannockburn Victoria Australia
| | - J. Pitt
- Victorian Clinical Genetics Services; Royal Children's Hospital; Melbourne Victoria Australia
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Soman SS, Tinson A. Development and evaluation of a simple and effective real time PCR assay for mitochondrial quantification in racing camels. Mol Cell Probes 2016; 30:326-330. [PMID: 27475303 DOI: 10.1016/j.mcp.2016.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/26/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
Camel racing is a popular sport in the Middle East region, where the demand is high for racing camels with higher stamina and endurance. Devising a technique to measure oxidative capacity and endurance in camels should be useful. Mitochondria are highly specialized organelles involved in metabolism in all higher organisms for sustaining life and providing energy for physical functions. The ratio of mitochondrial DNA (mtDNA) to nuclear DNA (nDNA) is often used as an estimate for the metabolic status of the tissue. A greater quantity of mitochondria per unit of tissue translates into greater oxidative capacity and endurance. In this report, we describe a simple, sensitive and efficient real-time PCR assay for the quantification of blood mitochondria in racing camels. The primer sequences selected for the SYBR green-based PCR assay included mitochondrial D-loop region, mitochondrial ATP6ase gene and the nuclear β-actin gene. The assay was validated using two groups of camels comprising racing and dairy camels. The racing camels demonstrated a higher mtDNA/nDNA ratio compared with dairy camels based on the ΔΔCt values, with a higher variability among racing camels. The mean ΔΔCt values of adult and young racing camels did not vary considerably. The findings show that the present assay can be used as an evaluative tool for racing camels.
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Affiliation(s)
- Soja Saghar Soman
- Hilli Embryo Transfer Center, Management of Scientific Centers and Presidential Camels, Department of President's Affairs, Al Ain, United Arab Emirates.
| | - Alex Tinson
- Hilli Embryo Transfer Center, Management of Scientific Centers and Presidential Camels, Department of President's Affairs, Al Ain, United Arab Emirates
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Lemieux H, Boemer F, van Galen G, Serteyn D, Amory H, Baise E, Cassart D, van Loon G, Marcillaud-Pitel C, Votion DM. Mitochondrial function is altered in horse atypical myopathy. Mitochondrion 2016; 30:35-41. [PMID: 27374763 DOI: 10.1016/j.mito.2016.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/30/2016] [Accepted: 06/28/2016] [Indexed: 12/31/2022]
Abstract
Equine atypical myopathy in Europe is a fatal rhabdomyolysis syndrome that results from the ingestion of hypoglycin A contained in seeds and seedlings of Acer pseudoplatanus (sycamore maple). Acylcarnitine concentrations in serum and muscle OXPHOS capacity were determined in 15 atypical myopathy cases. All but one acylcarnitine were out of reference range and mitochondrial respiratory capacity was severely decreased up to 49% as compared to 10 healthy controls. The hallmark of atypical myopathy thus consists of a severe alteration in the energy metabolism including a severe impairment in muscle mitochondrial respiration that could contribute to its high death rate.
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Affiliation(s)
- Hélène Lemieux
- Faculty Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - François Boemer
- Biochemical Genetics Laboratory, Human Genetics, CHU Liege, University of Liege, Belgium
| | - Gaby van Galen
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Didier Serteyn
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium; Centre of Oxygen, Research and Development, University of Liege, Liege, Belgium
| | - Hélène Amory
- (c)Equine Clinic, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Etienne Baise
- (e)Department of Animal Productions: Biostatistics, Economy and Animal Selection, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | - Dominique Cassart
- Department of Pathology, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium
| | | | | | - Dominique-M Votion
- (i)Equine Pole, Fundamental and Applied Research for Animals and Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Belgium.
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Bochnia M, Scheidemann W, Ziegler J, Sander J, Vollstedt S, Glatter M, Janzen N, Terhardt M, Zeyner A. Predictive value of hypoglycin A and methylencyclopropylacetic acid conjugates in a horse with atypical myopathy in comparison to its cograzing partners. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Bochnia
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
| | | | - J. Ziegler
- Department of Molecular Signal Processing; Leibniz Institute of Plant Biochemistry; Halle (Saale) Germany
| | - J. Sander
- Screening Labor Hanover; Ronnenberg Germany
| | - S. Vollstedt
- Traditional Chinese Equine Medicine; Bokholt-Hanredder Germany
| | - M. Glatter
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
| | - N. Janzen
- Screening Labor Hanover; Ronnenberg Germany
- Department of Clinical Chemistry; Hanover Medical School; Hanover Germany
| | | | - A. Zeyner
- Institute of Agricultural and Nutritional Sciences; Group Animal Nutrition; Martin Luther University Halle-Wittenberg; Halle (Saale) Germany
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Westermann CM, van Leeuwen R, van Raamsdonk LWD, Mol HGJ. Hypoglycin A Concentrations in Maple Tree Species in the Netherlands and the Occurrence of Atypical Myopathy in Horses. J Vet Intern Med 2016; 30:880-4. [PMID: 26995161 PMCID: PMC4913566 DOI: 10.1111/jvim.13927] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/15/2016] [Accepted: 02/18/2016] [Indexed: 11/28/2022] Open
Abstract
Background Atypical myopathy (AM) in horses is caused by the plant toxin hypoglycin A, which in Europe typically is found in the sycamore maple tree (Acer pseudoplatanus). Owners are concerned about whether their horses are in danger if they graze near maple trees. Hypothesis/Objectives To measure hypoglycin A in the most common maple tree species in the Netherlands, and to determine whether concentration of toxin is a predictor of AM in horses. Methods A total of 278 samples of maple tree leaves, sprouts, and seeds were classified by species. Mean concentrations of hypoglycin A were compared for the type of sample, the season and the occurrence of AM in the pasture (non‐AM versus AM). Statistical analysis was performed using generalized a linear model (SPPS22). Results Almost all Acer pseudoplatanus samples contained hypoglycin A, with concentrations differing significantly among sources (P < .001). Concentrations were significantly higher in seeds from the AM group than in seeds from the non‐AM group (856 ± 677 and 456 ± 358 mg/kg, respectively; P = .039). In sprouts and leaves this was not the case. Acer platanoides and Acer campestre samples did not contain detectable concentrations of hypoglycin A. Conclusions and clinical importance Acer platanoides and campestre seem to be safe around paddocks and pastures, whereas almost all Acer pseudoplatanus samples contained hypoglycin A. In all AM cases, Acer pseudoplatanus was found. Despite significantly higher concentration of hypoglycin A in seeds of pastures where AM has occurred, individual prediction of AM cannot be made by measuring these concentrations because of the high standard deviation.
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Affiliation(s)
- C M Westermann
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | | | | | - H G J Mol
- RIKILT-Wageningen UR, Wageningen, the Netherlands
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McKenzie RK, Hill FI, Habyarimana JA, Boemer F, Votion DM. Detection of hypoglycin A in the seeds of sycamore (Acer pseudoplatanus) and box elder (A. negundo) in New Zealand; the toxin associated with cases of equine atypical myopathy. N Z Vet J 2015; 64:182-7. [PMID: 26593855 DOI: 10.1080/00480169.2015.1123123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CASE HISTORY AND CLINICAL FINDINGS During April and May 2014 four horses aged between 5 months and 9 years, located in the Canterbury, Marlborough and Southland regions, presented with a variety of clinical signs including recumbency, stiffness, lethargy, dehydration, depression, and myoglobinuria suggestive of acute muscle damage. Two horses were subjected to euthanasia and two recovered. In all cases seeds of sycamore maple (Acer pseudoplatanus) or box elder (A. negundo) were present in the area where the horse had been grazing. LABORATORY INVESTIGATION The samaras (seeds) of some Acer spp. may contain hypoglycin A, that has been associated with cases of atypical myopathy in Europe and North America. To determine if hypoglycin A is present in the samaras of Acer spp. in New Zealand, samples were collected from trees throughout the country that were associated with historical and/or current cases of atypical myopathy, and analysed for hypoglycin A. Serum samples from the four cases and four unaffected horses were analysed for the presence of hypoglycin A, profiles of acylcarnitines (the definitive diagnosis for atypical myopathy) and activities of creatine kinase and aspartate aminotransferase.Markedly elevated serum activities of creatine kinase and aspartate aminotransferase, and increased concentrations of selected acylcarnitines were found in the case horses. Hypoglycin A was detected in the serum of those horses but not in the healthy controls. Hypoglycin A was detected in 10/15 samples of samaras from sycamore maple and box elder from throughout New Zealand. DIAGNOSIS Cases of atypical myopathy were diagnosed on properties where samaras containing hypoglycin A were also found. CLINICAL RELEVANCE Sycamore and box elder trees in New Zealand are a source of hypoglycin A associated with the development of atypical myopathy. If pastured horses present with clinical and biochemical signs of severe muscle damage then the environment should be checked for the presence of these trees. Horses should be prevented from grazing samaras from Acer spp. in the autumn.
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Affiliation(s)
- R K McKenzie
- a Matamata Veterinary Services , 26 Tainui St, Matamata 3400 , New Zealand
| | - F I Hill
- b Gribbles Veterinary Pathology , PO Box 536, Palmerston North 4440 , New Zealand
| | - J A Habyarimana
- c Department of Functional Sciences, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine , University of Liège , Belgium
| | - F Boemer
- d Biochemical Genetics Laboratory, Human Genetics, CHU Liège , University of Liège , Belgium
| | - D M Votion
- e Equine Pole, Fundamental and Applied Research for Animals and Health, Faculty of Veterinary Medicine , University of Liège , Belgium
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Hypoglycin A Content in Blood and Urine Discriminates Horses with Atypical Myopathy from Clinically Normal Horses Grazing on the Same Pasture. PLoS One 2015; 10:e0136785. [PMID: 26378918 PMCID: PMC4574941 DOI: 10.1371/journal.pone.0136785] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/07/2015] [Indexed: 11/24/2022] Open
Abstract
Hypoglycin A (HGA) in seeds of Acer spp. is suspected to cause seasonal pasture myopathy in North America and equine atypical myopathy (AM) in Europe, fatal diseases in horses on pasture. In previous studies, this suspicion was substantiated by the correlation of seed HGA content with the concentrations of toxic metabolites in urine and serum (MCPA-conjugates) of affected horses. However, seed sampling was conducted after rather than during an outbreak of the disease. The aim of this study was to further confirm the causality between HGA occurrence and disease outbreak by seed sampling during an outbreak and the determination of i) HGA in seeds and of ii) HGA and MCPA-conjugates in urine and serum of diseased horses. Furthermore, cograzing healthy horses, which were present on AM affected pastures, were also investigated. AM-pastures in Germany were visited to identify seeds of Acer pseudoplatanus and serum (n = 8) as well as urine (n = 6) from a total of 16 diseased horses were analyzed for amino acid composition by LC-ESI-MS/MS, with a special focus on the content of HGA. Additionally, the content of its toxic metabolite was measured in its conjugated form in body fluids (UPLC-MS/MS). The seeds contained 1.7–319.8 μg HGA/g seed. The content of HGA in serum of affected horses ranged from 387.8–8493.8 μg/L (controls < 10 μg/L), and in urine from 143.8–926.4 μg/L (controls < 10 μg/L), respectively. Healthy cograzing horses on AM-pastures showed higher serum (108.8 ± 83.76 μg/L) and urine concentrations (26.9 ± 7.39 μg/L) compared to control horses, but lower concentrations compared to diseased horses. The range of MCPA-carnitine and creatinine concentrations found in diseased horses in serum and urine were 0.17–0.65 mmol/L (controls < 0.01), and 0.34–2.05 μmol/mmoL (controls < 0.001), respectively. MCPA-glycine levels in urine of cograzing horses were higher compared to controls. Thus, the causal link between HGA intoxication and disease outbreak could be further substantiated, and the early detection of HGA in cograzing horses, which are clinically normal, might be a promising step in prophylaxis.
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Żuraw A, Dietert K, Kühnel S, Sander J, Klopfleisch R. Equine atypical myopathy caused by hypoglycin A intoxication associated with ingestion of sycamore maple tree seeds. Equine Vet J 2015; 48:418-21. [DOI: 10.1111/evj.12460] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- A. Żuraw
- Department of Veterinary Pathology; Freie Universität Berlin; Germany
| | - K. Dietert
- Department of Veterinary Pathology; Freie Universität Berlin; Germany
| | - S. Kühnel
- Tierärztliche Klinik für Pferde; Dallgow-Döberitz OT Seeburg; Germany
| | - J. Sander
- Screening-Labor Hannover; Ronnenberg Germany
| | - R. Klopfleisch
- Department of Veterinary Pathology; Freie Universität Berlin; Germany
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McKenzie RK, Gibson IR, Ritmeester A. Three cases of a presumptive atypical myopathy in New Zealand horses. N Z Vet J 2013; 61:367-72. [DOI: 10.1080/00480169.2013.796436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Votion DM, van Galen G, Sweetman L, Boemer F, de Tullio P, Dopagne C, Lefère L, Mouithys-Mickalad A, Patarin F, Rouxhet S, van Loon G, Serteyn D, Sponseller BT, Valberg SJ. Identification of methylenecyclopropyl acetic acid in serum of European horses with atypical myopathy. Equine Vet J 2013; 46:146-9. [PMID: 23773055 DOI: 10.1111/evj.12117] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/09/2013] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY It is hypothesised that European atypical myopathy (AM) has a similar basis as seasonal pasture myopathy in North America, which is now known to be caused by ingestion of hypoglycin A contained in seeds from the tree Acer negundo. Serum from horses with seasonal pasture myopathy contained the conjugated toxic metabolite of hypoglycin A, methylenecyclopropyl acetic acid (MCPA). STUDY DESIGN Retrospective study on archived samples. OBJECTIVES 1) To determine whether MCPA-carnitine was present in serum of European horses confirmed to have AM; 2) to determine whether Acer negundo or related Acer species were present on AM pastures in Europe. METHODS Concentrations of MCPA-carnitine were analysed in banked serum samples of 17 AM horses from Europe and 3 diseased controls (tetanus, neoplasia and exertional rhabdomyolysis) using tandem mass spectrometry. Atypical myopathy was diagnosed by characteristic serum acylcarnitine profiles. Pastures of 12 AM farms were visited by experienced botanists and plant species were documented. RESULTS Methylenecyclopropyl acetic acid-carnitine at high concentrations (20.39 ± 17.24 nmol/l; range 0.95-57.63 nmol/l; reference: <0.01 nmol/l) was identified in serum of AM but not disease controls (0.00 ± 0.00 nmol/l). Acer pseudoplatanus but not Acer negundo was present on all AM farms. CONCLUSIONS Atypical myopathy in Europe, like seasonal pasture myopathy in North America, is highly associated with the toxic metabolite of hypoglycin A, MCPA-carnitine. This finding coupled with the presence of a tree of which seeds are known to also contain hypoglycin A indicates that ingestion of Acer pseudoplatanus is the probable cause of AM. This finding has major implications for the prevention of AM.
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Affiliation(s)
- D-M Votion
- Equine Clinic, Faculty of Veterinary Medicine, University of Liege, Belgium
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van der Kolk JH, Boelens R, Halkes SB, Wijnberg ID, de Sain-van der Velden MG, Ippel JH. Some notes on fatal acquired multiple acyl-CoA dehydrogenase deficiency (MADD) in a two-year-old warmblood stallion and European tar spot (Rhytisma acerinum). Vet Q 2013; 33:47-51. [DOI: 10.1080/01652176.2012.758904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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van Galen G, Cerri S, Porter S, Saegerman C, Lefere L, Roscher K, Marr C, Amory H, Votion DM. Traditional and quantitative assessment of acid-base and shock variables in horses with atypical myopathy. J Vet Intern Med 2012. [PMID: 23193982 DOI: 10.1111/jvim.12003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Descriptions of acid-base disturbances in atypical myopathy (AM) are limited. OBJECTIVES Describe and compare traditional and quantitative acid-base abnormalities and cardiovascular shock status in horses with AM at admission. ANIMALS 34 horses with AM, 15 healthy controls. METHODS Retrospective case-control study. Records were searched for shock variables (packed cell volume [PCV], blood urea nitrogen [BUN], heart and respiratory rate) and acid-base variables (venous blood gas analysis, electrolytes, total protein, lactate) on admission. Base excess (BE) of free water (BEfw), chloride (BEcl), total protein (BEtp), and unidentified anions (BEua), anion gap (AG), measured strong ion difference (SIDm), and concentration of total nonvolatile weak acids ([Atot]) were calculated. Acid-base classifications, using simplified strong ion model and traditional approach, and shock grades were assigned. A 2-sample Wilcoxon rank-sum test and Bonferroni correction compared variables in AM cases versus control horses. Significance was P < .05/16 for acid-base and P < .05/5 for shock variables. RESULTS Tachycardia, tachypnea, and normal to increased PCV and BUN were common in AM cases. Respiratory, metabolic acid-base alterations, or both were mainly caused by respiratory alkalosis, lactic acidosis, and SIDm alkalosis, alone or in combination. Evaluated variables (except pH, potassium concentration, total protein, and related calculations) were significantly different (P < .001) between AM cases and control horses. The strong ion model provided a more accurate assessment than the traditional approach and identified mixed derangements. CONCLUSIONS AND CLINICAL IMPORTANCE Acid-base derangements should be evaluated in horses with AM and this preferably with the strong ion model.
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Affiliation(s)
- G van Galen
- Department of Epidemiology, Unité de recherche en epidémiologie et analyse de risques appliquées aux sciences vétérinaires, FMV University of Liege, Belgium.
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Valberg SJ, Sponseller BT, Hegeman AD, Earing J, Bender JB, Martinson KL, Patterson SE, Sweetman L. Seasonal pasture myopathy/atypical myopathy in North America associated with ingestion of hypoglycin A within seeds of the box elder tree. Equine Vet J 2012; 45:419-26. [PMID: 23167695 DOI: 10.1111/j.2042-3306.2012.00684.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 09/21/2012] [Indexed: 11/27/2022]
Abstract
REASONS FOR PERFORMING STUDY We hypothesised that seasonal pasture myopathy (SPM), which closely resembles atypical myopathy (AM), was caused by ingestion of a seed-bearing plant abundant in autumn pastures. OBJECTIVES To identify a common seed-bearing plant among autumn pastures of horses with SPM, and to determine whether the toxic amino acid hypoglycin A was present in the seeds and whether hypoglycin metabolites were present in SPM horse serum or urine. METHODS Twelve SPM cases, 11 SPM pastures and 23 control farms were visited to identify a plant common to all SPM farms in autumn. A common seed was analysed for amino acid composition (n = 7/7) by GC-MS and its toxic metabolite (n = 4/4) identified in conjugated form in serum [tandem mass spectrometry (MS/MS)] and urine [gas chromatography (GC) MS]. Serum acylcarnitines and urine organic acid profiles (n = 7) were determined for SPM horses. RESULTS Seeds from box elder trees (Acer negundo) were present on all SPM and 61% of control pastures. Hypoglycin A, known to cause acquired multiple acyl-CoA dehydrogenase deficiency (MADD), was found in box elder seeds. Serum acylcarnitines and urine organic acid profiles in SPM horses were typical for MADD. The hypoglycin A metabolite methylenecyclopropylacetic acid (MCPA), known to be toxic in other species, was found in conjugated form in SPM horse serum and urine. Horses with SPM had longer turn-out, more overgrazed pastures, and less supplemental feeding than control horses. POTENTIAL RELEVANCE For the first time, SPM has been linked to a toxin in seeds abundant on autumn pastures whose identified metabolite, MCPA, is known to cause acquired MADD, the pathological mechanism behind SPM and AM. Further research is required to determine the lethal dose of hypoglycin A in horses, as well as factors that affect annual seed burden and hypoglycin A content in Acer species in North America and Europe.
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Affiliation(s)
- S J Valberg
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA.
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Votion DM. The story of equine atypical myopathy: a review from the beginning to a possible end. ISRN VETERINARY SCIENCE 2012; 2012:281018. [PMID: 23762581 PMCID: PMC3671727 DOI: 10.5402/2012/281018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 09/25/2012] [Indexed: 11/23/2022]
Abstract
Atypical myopathy (AM) is a frequently fatal seasonal pasture myopathy that emerges in Europe. Outbreaks are of an acute and unexpected nature and practitioners should be prepared to handle these critically ill patients. This review retraces the history of AM and describes results of epidemiological investigations that were conducted to raise hypotheses concerning the etiology of this devastating disease as well as to be able to suggest potential preventive measures. Also, clinical studies have contributed to a better definition and recognition of the syndrome, whereas elucidation of the pathological process, identified as a multiple acyl-CoA dehydrogenase deficiency (MADD), was a great step forward improving medical management of AM and guiding the search for the etiological agent towards toxins that reproduce the identified defect. Treatment plans can be extrapolated from the described clinical signs and metabolic problems, but they remain limited to supportive care until the causative agent has been identified with certainty. Since treatment is still unsuccessful in the majority of cases, the main emphasis is currently still on prevention. This paper aims at being a practical support for equine clinicians dealing with AM and is based on discussion and comparison of the currently available scientific data.
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Affiliation(s)
- Dominique-Marie Votion
- Equine Clinic, Faculty of Veterinary Medicine, University of Liege, Boulevard de Colonster 20 B41, 4000 Liege, Belgium
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