The use of inflammatory markers as a diagnostic and prognostic approach in neonatal calves with septicaemia

Optimization of Antimicrobial Use for Sepsis in Calves: Bayesian Evaluation of Existing and Novel Sepsis Scores

Early recognition and rapid appropriate antimicrobial treatment is essential for survival of sepsis. To date, it is unclear which sepsis score should be used for an early diagnosis in calves. The objective of this study was to evaluate two existing scores (Trefz and Fecteau), three novel calf sepsis screening models (CSS, CSSA, CSSB), and blood culture as diagnostic test for sepsis, using Bayesian latent class evaluation. A total of 131 sick calves were included in this study. Sepsis prevalence was 45%, 27%, 56%, 47%, and 55%, when using the Trefz score, Fecteau score, CSS, CSSA, and CSSB, respectively, and 22% had a relevant positive blood culture. The newly established models CSS (including ≥2 SIRS-criteria and abnormal mental state) and CSSB (alternative model CSS for practice, substituting abnormal leukocyte count with mucosae) had the highest sensitivity, with 86% and 84%, respectively, and could be interesting screening tests for sepsis. Sensitivity of the existing Trefz and Fecteau score was 70% and 35-39%, respectively. The presented new sepsis scoring systems have potential as screening tests to identify calves at risk, after which a calf-side diagnostic test is advised to confirm the diagnosis. Its use might aid in the rationalization of antimicrobial use in critically ill calves.

Clinical and laboratory predictors for bacteremia in critically ill calves

BACKGROUND

Sepsis is a main contributor to calf mortality, but diagnosis is difficult.

OBJECTIVES

Develop and validate a predictive model for bacteremia in critically ill calves (CIC).

ANIMALS

A total of 334 CIC, sampled for blood culture.

METHODS

Cross-sectional study. Multivariable logistic regression and classification tree analysis on clinical, ultrasonographic, and laboratory variables were performed on a dataset including all animals. Model validation was done on 30% of the dataset. Similar statistics (except validation) were performed on a subset of the database (n = 143), in which presumed contaminants were excluded.

RESULTS

The best performing model to predict bacteremia, taking all detected bacteria into account, included tachypnea, tachycardia, acidemia, hypoglycemia, venous hypoxemia, and hypoproteinemia. Sensitivity and specificity of this model were 70.6% and 98.0%, respectively, but decreased to 61.5% and 91.7% during model validation. The best-performing model, excluding presumed contaminants, included abnormal temperature, heart rate, absence of enteritis, hypocalcemia, and hyperlactatemia as risk factors for bacteremia. Sensitivity and specificity of this model were 71.4% and 93.9%, respectively. Both classification trees performed less well in comparison to logistic regression. The classification tree excluding presumed contaminants, featured hypoglycemia, absence of diarrhea, and hyperlactatemia as risk factors for bacteremia. Sensitivity and specificity were 39.4% and 92.7%, respectively.

CONCLUSIONS AND CLINICAL IMPORTANCE

Hypoglycemia, hyperlactatemia, and hypoproteinemia seem relevant in assessing bacteremia in CIC. The performance of these models based on basic clinical and blood variables remains insufficient to predict bacteremia.

Investigation of the diagnostic and prognostic importance of Tumor Necrosis Factor-alfa (TNF-α), Procalcitonin (PCT), Interleukin-6 (IL-6) and Haptoglobin (HP) in calves with neonatal diarrhea

This study aims to investigate the effects of Procalcitonin, Tumor Necrosis Factor-alpha, Interleukin-6, and Haptoglobin levels on the prognosis of calves classified according to the severity of diarrhea. The animal material comprised 48 diarrheic calves of different breeds and sexes, aged 1-30 days, and 16 healthy calves aged 1-30 days. The 48 diarrheic calves used were divided into 3 groups, each consisting of 16 calves. Group 1 was designed as Viral (Rota + Corona n = 16), Group 2 as Bacterial (E. coli n = 16), and Group 3 as Parasitic (Cryptosporidiosis n = 16). Each of these groups was further divided into 2 subgroups (moderate and severe subgroups). Blood samples were taken from the diarrheic calves before treatment (0 h) and at 24 and 72 h after treatment. Complete blood count, biochemical, blood gas analyses, and ELISA tests were performed. It was determined that 18.75 % (9/48) of the 48 diarrheic calves included in the study died, while 81.25 % (39/48) survived. The highest mortality rate among the patient groups was observed in the severe rota + corona group (37.5 %). The average PCT concentration in the diarrheic calves in the Rota-corona and E. coli groups at 0 and 24 hours was found to be higher than both the healthy calves and the diarrheic calves in the Cryptosporidium spp. group (P<0.001). This increase was also observed in the Cryptosporidium spp. group at 72 h (P<0.001). A positive and moderate correlation was observed between Procalcitonin and TNF-α (r = 0.603, P<0.001). As a result, it was concluded that the Procalcitonin value, along with other tests, could be used as a biomarker to determine the prognosis of the disease in diarrheic calves, regardless of the etiological agent. This study was evaluated as an original study in which cytokines and acute phase proteins were investigated before and after treatment, with diarrhea divided into subgroups.

Nucleotide sequence variants, gene expression and serum profile of immune and antioxidant markers associated with bacterial diarrhea susceptibility in Barki lambs

BACKGROUND

Despite the fact that diarrhea is more accurately described as a clinical symptom than a disease. Diarrhea is one of the most important issues in ovine medicine, particularly in lambs, and because of high morbidity and mortality rate, sluggish growth performance, and veterinary costs, it is believed to be a major source of economic loss. Salmonella and enterotoxigenic Escherichia coli are the most common and commercially significant agents responsible for diarrhea.

OBJECTIVE

The objective of this study was to monitor the nucleotide sequence variations, gene expression, serum inflammatory and oxidative stress biomarkers in diarrheic lambs. Another aim was to identify different pathotypes and virulence genes of Salmonella and E. coli causing diarrhea.

METHODOLOGY

Blood samples were taken from 50 Barki who were diarrheal and 50 who appeared to be healthy, and then divided in 3 portions, with EDTA added to the first part for CBC, DNA and RNA extraction. The second sample received 5000 I.U. of heparin calcium, and a clean plain tube was used for the third component. The second and third sections were centrifuged to extract serum and plasma until the biochemical and immunological analysis was completed. Fecal samples were collected for bacteriological examination, and the bacteria were identified by PCR analysis. PCR-DNA sequencing was conducted for immune (SELL, JAK2, SLC11A1, IL10, FEZF1, NCF4, LITAF, SBD2, NFKB, TNF-α, IL1B, IL6, LGALS, and CATH1), antioxidant (SOD1, CAT, GPX1, GST, Nrf2, Keap1, HMOX1, and NQO1), and GIT health (CALB1, GT, and MUC2) genes in healthy and diarrheic lambs.

RESULTS

Virulent genetic markers of pathogenic characteristics of E. coli (astA, Vt2e (Stx2e), CFA/I, groES and luxS) and Salmonella (invA, SopB, bcfC and avrA) were detected in all diarrheic lambs. PCR-DNA sequencing of immune, antioxidant and intestinal health genes found eleven single nucleotide polymorphisms (SNPs) linked to either diarrhea resistance or susceptibility in Barki lambs. Transcript levels of immune, antioxidant, and GIT health (CALB1, GT, and MUC2) genes varied between healthy and diarrheic lambs. Nucleotide sequence variation of the genes under inquiry between reference sequences in GenBank and those of the animals under investigation verified all identified SNPs. Significant (P = 0.001) erythrocytosis, neutrophilic leukocytosis, with lymphocytopenia were observed in diarrheic lambs. Significant (P = 0.001) increases in serum IL-1α, IL-1β, IL-6, TNF-α (90.5 ± 1.7, 101.8 ± 1.7, 72.3 ± 6.6, 71.26 ± 4.89 Pg/ml, respectively), serum Fb, Cp, Hp, SAA (230.7 ± 12.4 mg/dl, 6.5 ± 0.07 mg/dl, 2.5 ± 0.09 g/dl, 7.4 ± 0.4 mg/L, respectively), free radicals (MDA, NO), cortisol (6.91 ± 0.18 μg/dl) and growth hormone, with significant (P = 0.001) decreases in serum IL-10 (81.71 ± 1.05 Pg/ml), antioxidants (CAT, GPx), insulin, triiodothyronine (T3) and thyroxine (T4) in diarrheic lambs.

CONCLUSIONS

The study's findings provided credence to the theory that marker-assisted selection (MAS) could be used to predict and prevent diarrhea in Barki sheep by selecting lambs based on SNPs in genes linked to inflammation, antioxidants, and intestinal health. In order to establish an efficient management protocol and determine the most susceptible risk period for disease occurrence, gene expression profiles of the genes under investigation, pro-inflammatory cytokines and acute phase proteins may also be utilized as proxy biomarkers for lamb enteritis.

Determination of systemic inflammation response index (SIRI), systemic inflammatory index (SII), HMGB1, Mx1 and TNF levels in neonatal calf diarrhea with systemic inflammatory response syndrome

The objective of this study was to examine the values of MX dynamin-like GTPase 1 (Mx1), high mobility group box-1 (HMGB1), systemic inflammatory response index (SIRI), systemic inflammatory index (SII), tumor necrosis factor (TNF), and other hematological indices in calves with systemic inflammatory response syndrome (SIRS). The study material was divided into two groups: the SIRS group (comprising 13 calves) and the control group (comprising 10 calves). The independent samples t-test and Mann-Whitney U test were employed for normally distributed and non-normally distributed data, respectively. The relationship between the two groups was determined using Spearman correlation coefficient analysis. Significant differences were identified between the SIRS group and the control group with regard to white blood cell (WBC; P < 0.05), neutrophil (NEU; P < 0.01), and neutrophil-to-lymphocyte ratio (NLR; P < 0.001) values, in addition to SIRI (P < 0.05), SII (P < 0.01) values. Furthermore, HMGB1 (P < 0.001), Mx1 (P < 0.05), and TNF values (P < 0.001) demonstrated notable disparities between the two groups. As a result of this study, it was concluded that there were significant increases in inflammatory hematological indices, as well as in the levels of HMGB1, Mx1, and TNF, in calves with SIRS.

Prognostic potential of inflammatory markers, oxidative status, thrombocyte indices, and renal biochemical markers in neonatal calf diarrhoea-induced systemic inflammatory response syndrome

The study aimed to assess the prognostic value of inflammatory markers, indicators of oxidative stress, thrombocyte indices, and renal biochemical markers in neonatal calf diarrhoea (NCD) induced by systemic inflammatory response syndrome (SIRS) upon admission. A prospective, observational, and case-control study was conducted on 56 calves diagnosed with NCD. Mean concentrations of interleukin-6 (IL-6), malondialdehyde (MDA), glutathione (GSH), mean platelet volume (MPV), platelet distribution width (PDW), blood urea nitrogen (BUN), and creatinine (Crea) were measured. Furthermore, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were also calculated for SIRS survivors [SIRS (survivor)] and non-survivors [SIRS (non-survivor)] induced by NCD. A prognostic cut-off value for predicting the prognosis of the SIRS's induced by NCD was obtained via receiver operating characteristic (ROC) curve analysis. Upon admission, the SIRS (non-survivor) calves had significantly higher (P < .001) average levels of IL-6, MDA, BUN, Crea, MPV, and PDW compared to the SIRS (survivor) calves and significantly lower (P < .001) average levels of GSH. Despite an apparent increase in the NLR and PLR values of calves diagnosed with SIRS, no significant difference was found between the survival and non-survivor SIRS cases. Positive predictive values (PPVs) for survival were determined as 100 %, 100 %, 80 %, 100 %, 80 %, and 80 %, respectively, using cut-off values of IL-6 (≤259.67 ng/L), MDA (≤2.87 nmol/mL), MPV (≤12.5 fL), PDW (≤34.25 %), BUN (≤168.3 mg/dL), and Crea (≤2.11 mg/dL). The determined threshold values are those obtained upon admission to the hospital. Based on the sensitivity, specificity, and PPVs derived from the ROC analysis, it has been concluded that IL-6, MDA, MPV, PDW, BUN, and Crea are the most relevant biomarkers used for predicting the prognosis of NCD-induced SIRS in calves. Furthermore, it is also noteworthy that IL-6 exhibited the highest effectiveness among all biomarkers.

Procalcitonin as an Endogenous Biomarker for Mastitis in Cows

Mastitis is one of the most common diseases of dairy cows. Procalcitonin (PCT) has been described as an endogenous inflammatory biomarker for bacterial infections. The aim of this study was to find possible correlations between PCT concentrations in the serum and milk of cows with mastitis and their clinical signs and disease progression. In total, 88 dairy cows were examined, of which 30 animals were diagnosed with clinical mastitis, 30 had subclinical mastitis, and 28 were designated as a healthy control group. The diseased animals were re-examined after 12 days. All PCT levels in this study were determined by a species-specific ELISA. All three groups could be differentiated from each other based on serum and milk PCT levels. The animals with clinical mastitis showed the highest mean concentrations of PCT (serum: 2641 pg/mL; milk: 1326 pg/mL), and the lowest PCT concentrations were found in the healthy control group (serum: 1166 pg/mL; milk: 176 pg/m). Over the course of the disease, results from the kinetics study showed that PCT levels remained high for the entire observation period. The results from this study showed that the PCT concentration could be used to differentiate between clinical mastitis, subclinical mastitis, and healthy cows.

The relationship between serum cytokine profile and vitamin D in calves with neonatal diarrhea

It is important to know the characteristics of the immunological response in newborn calf diarrhea, which is often caused by bacterial, viral and protozoal pathogens. Cytokinesare proteins that serve as chemical messengers to regulate theinnate and adaptive arms of theimmune response. Changes in circulatory cytokine levels provide valuable information for understanding the pathophysiological process and monitoring disease progression and inflammation. Vitamin D has important immunomodulatory effects, which include enhancing the innate immune system and inhibiting adaptative immune responses. The objective of this study was to evaluate the relationship between serum cytokine profile and vitamin D level in neonatal calves with diarrhea. The study population was comprised of 40 neonatal calves, 32 of which had diarrhea and 8 of which were healthy calves. The calves with diarrhea were allocated to four groups according to bacterial (Escherichia coli), viral (Rotavirus, Coronavirus) and protozoal (Cryptosporidium parvum) etiologies. Circulatory vitamin D metabolites (25-hydroxyvitamin D, 1,25-dihydroxyvitamin D) and cytokines (TNF-α, IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13 and IL-17) in the calves were determined. There was no statistically significant difference among the groups in 25-hydroxyvitamin D levels. 1,25-dihydroxyvitamin D levels were higher in Coronavirus and E. coli groups compared to the controls. Serum levels of all cytokines except for IL-13, were higher in E. coli group than those of the control group. As a result, differences in serum cytokines and vitamin D levels according to etiological factors in calf diarrhea indicate that vitamin D may play a role in the immune response in the disease.

Validation of new automated turbidimetric immunoassays for the measurement of haptoglobin and inter-α-trypsin inhibitor heavy chain H4 specific for the bovine species

BACKGROUND

Good strategical programs are required for the early detection of disease even in the absence of evident clinical signs, which is crucial in satisfying animal welfare. Haptoglobin (Hp) and inter-α-trypsin inhibitor heavy chain H4 (ITIH4) are acute phase proteins and good biomarkers of early inflammation in cattle, with plasma levels that significantly increase after injury or infection.

OBJECTIVES

We aimed to develop and validate two new immunoturbidimetric methods for Hp and ITIH4.

METHODS

Species-specific antibodies were obtained and used to develop the immunoassays. For the Hp assay, antibodies were fixed to latex microparticles to enhance detection. The immunoassays were set up in an automated analyzer to carry out validation studies. Reference intervals were calculated using Reference Value Advisor.

RESULTS

The Hp immunoturbidimetric method had a linear analytical range up to 0.40 mg/mL. The limit of detection (LoD) was 0.005 mg/mL, and the limit of quantification (LoQ) was 0.007 mg/mL. Total imprecision was less than 7%. Comparison with ELISA and single radial immunodiffusion (SRID) showed good correlation, whereas the comparison with the colorimetric method showed constant and proportional differences. The ITIH4 immunoassay showed linearity up to 5 mg/mL, and the LoD was 0.002 mg/mL. Total imprecision was less than 6%. Method comparison showed a good correlation with single radial immunodiffusion, both methods being equivalent. Bilirubin, triglycerides, and hemoglobin presented no interference in any of the assays. Reference intervals were 0.007-0.017 mg/mL for Hp and 0.2-0.7 mg/mL for ITIH4 in dairy cows 10 days before parturition.

CONCLUSIONS

Immunoturbidimetric methods developed for Hp and ITIH4 can measure basal and increased levels of these proteins, showing adequate precision, accuracy, and robustness.

Biomarkers of sepsis in pigs, horses and cattle: from acute phase proteins to procalcitonin

Sepsis is a complex clinical syndrome triggered by an inflammatory host response to an infection. It is usually complicated to detect and diagnose, and has severe consequences in human and veterinary health, especially when treatment is not started early. Therefore, efforts to detect sepsis accurately are needed. In addition, its proper diagnosis could reduce the misuse of antibiotics, which is essential fighting against antimicrobial resistance. This case is a particular issue in farm animals, as antibiotics have been traditionally given massively, but now they are becoming increasingly restricted. When sepsis is suspected in animals, the most frequently used biomarkers are acute phase proteins such as C-reactive protein, serum amyloid A and haptoglobin, but their concentrations can increase in other inflammatory conditions. In human patients, the most promising biomarkers to detect sepsis are currently procalcitonin and presepsin, and there is a wide range of other biomarkers under study. However, there is little information on the application of these biomarkers in veterinary species. This review aims to describe the general concepts of sepsis and the current knowledge about the biomarkers of sepsis in pigs, horses, and cattle and to discuss possible advances in the field.

Neopterin, procalcitonin, total sialic acid, paraoxonase-1 and selected haematological indices in calves with aspiration pneumonia

This study aims to determine serum neopterin, procalcitonin, total sialic acid (TSA), paraoxonase-1 (PON1), and some haematological indices in calves with aspiration pneumonia (ASP). The patient group consisted of 30 calves of the Simmental breed, 0–28 days old, diagnosed with ASP upon clinical examination, anamnesis, auscultation examination, and radiographic results. The control group consisted of 10 healthy calves, otherwise with the same characteristics. A significant difference was found between calves with ASP and the control group of calves in serum iron (Fe, P < 0.001), total iron-binding capacity (TIBC, P < 0.05), PON1, TSA, procalcitonin, neopterin, and total leukocyte count (WBC) indices as a result of the analyses (P < 0.001). Serum procalcitonin concentration was found to be 285.71 ng/ml in the ASP group and 30.34 ng/ml in the control group. Serum neopterin concentration was found to be 37.68 nmol/l in the ASP group and 15.14 nmol/l in the control group. Serum procalcitonin, neopterin, and TSA concentrations were found to be significantly higher in the ASP group compared to the control group. It was concluded that biomarkers such as serum procalcitonin, neopterin, and TSA are high in calves with ASP, and as a result, these markers provide diagnostically and prognostically important information.

Evaluation of Serum Iron and Ferritin Levels as Inflammatory Markers in Calves with Bovine Respiratory Disease Complex

Iron and ferritin have been used in human medicine for years to reveal the presence of inflammation. However, studies evaluating these parameters, especially in respiratory system diseases, are quite rare in veterinary medicine. We aimed to test the usability of serum Fe and Fe-related parameters [total iron-binding capacity (TIBC), unsaturated iron-binding capacity (UIBC) and transferrin saturation (TS) levels] as inflammatory and diagnostic biomarkers in calves with bovine respiratory disease complex (BRDC). To mark inflammation, some selected acute-phase proteins including serum ferritin and transferrin levels were measured because of their close relationship with iron metabolism. The material of this study consisted of 15 calves, aged 1-3 months with BRDC (Group I) and 10 healthy calves aged 1-3 months (Group II) based on the presence of respiratory clinical findings. Serum Fe, TIBC and TS levels were low and ferritin levels were high in Group I (P ≤ 0.001). The BRDC group was separated into two subgroups based on PCR results, namely Virus+ (n=9) and Virus- (n=6). The calves in the Virus+ group had significantly lower levels of Fe (P=0.001) and significantly higher values of ferritin (P=0.002), compared to the healthy group. On the basis of inter-group comparison and ROC analysis, we concluded that Fe (primarily), ferritin, TIBC and TS levels can be used as inflammatory biomarkers and possible diagnostic markers in the BRDC as useful, practical, inexpensive substitutes. As a suggestion, these parameters which are believed to play a role in the pathogenesis of the disease, can be used as potential prognostic biomarkers in studies involving treatment.

Assessment of Standing and Recumbent Restraint Positions and the Significance of Rumenotomy Techniques Based on the Profiles of Serum Amyloid a in Kano Brown Goats

Standing and lateral recumbency positions have been used as a standard approach for most surgical procedures for large and small ruminants, respectively, without appropriate attention to the associated surgical stress. The study aimed to assess the level of surgical stress in Kano Brown goats (KBGs) based on their serum amyloid A (SAA) profiles by undergoing rumenotomy in lateral recumbency (Rumen Skin Clamp Fixation-RSCF and Stay Suture Rumenotomy-SSR) and a standing position restraint. A total of 24 KBGs were equally allocated by number and sex in groups A, B, C, and D. Groups A and B underwent RSCF and SSR in lateral recumbency, respectively, while group D underwent a rumenotomy in a standing position performed in a custom made mobile small ruminant surgical chute. Animals in groups A, B, and D were diagnosed with rumen foreign bodies, whereas group C was used as a control with a negative diagnosis. At 48 h post-rumenotomy, the mean SAA concentration in group B (137.88±66.87 g/L) was significantly higher (P<0.05) than the value in group C (34.59±0.57 g/L). The females in group B had a significantly higher (P<0.05) mean concentration of SAA at 48 hours (210.15±123.73 g/L) than groups C (35.18±0.08 g/L) and D (48.35±12.15 g/L). In group A, at 24 hours, SAA concentration (115.61±20.96 µg/L) was significantly higher (P<0.05) than that of group B (31.51±2.59 µg/L) and group C (34.86±3.21 µg/L) in males. Rumenotomy in the standing restraint position was associated with minimal surgical stress, hence it’s recommended over the conventional lateral recumbent position techniques.

Neopterin, procalcitonin, clinical biochemistry, and hematology in calves with neonatal sepsis

This study aims to determine how neopterin, procalcitonin, biochemical and hematological parameters change during treatment of calves with neonatal sepsis. A total of 25 calves divided into two groups. Sepsis group was composed of 15 newborn calves aged 0–10 days which met neonatal sepsis criteria, but did not receive any treatment. Control group included 10 healthy calves aged 0–10 days. Clinical examinations (respiratory rate, rectal temperature, heart rate, capillary refill time, sucking reflex) were performed at certain times before (0th h) and during (12th, 24th, 48th, and 72th h) the treatment. The blood was taken from the jugular vein from the sepsis group before (0th h) and during the treatment (12th, 24th, 48th, and 72nd h) and once from the control group. Procalcitonin pretreatment (0th h) and control group concentrations were found as 178.08 ± 2.4 (pg/mL) and 42.78 ± 1.25 (pg/mL), respectively (p < 0.001). Neopterin pretreatment (0th h) and control group concentrations were determined as 14.44 ± 0.30 (ng/mL) and 3.63 ± 0.29 (ng/mL), respectively (p < 0.001). As a result, neopterin and procalcitonin concentration decreased along with the treatment, confirming the presence of sepsis in calves and suggesting that sepsis could be a prognostic indicator. Therefore, both procalcitonin and neopterin can be prognostic and diagnostic in calves with sepsis.