Use of a Granulocyte Immunofluorescence Assay Designed for Humans for Detection of Antineutrophil Cytoplasmic Antibodies in Dogs with Chronic Enteropathies

BACKGROUND

Perinuclear antineutrophil cytoplasmic antibodies (pANCA) previously have been shown to be serum markers in dogs with chronic enteropathies, with dogs that have food-responsive disease (FRD) having higher frequencies of seropositivity than dogs with steroid-responsive disease (SRD). The indirect immunofluorescence (IIF) assay used in previous publications is time-consuming to perform, with low interobserver agreement.

HYPOTHESIS/OBJECTIVES

We hypothesized that a commercially available granulocyte IIF assay designed for humans could be used to detect perinuclear antineutrophil cytoplasmic antibodies in dogs.

ANIMALS

Forty-four dogs with FRD, 20 dogs with SRD, 20 control dogs, and 38 soft-coated wheaten terrier (SCWT) or SCWT-cross dogs.

METHODS

A granulocyte assay designed for humans was used to detect pANCA, cANCA, and antinuclear antibodies (ANA), as well as antibodies against proteinase-3 protein (PR-3) and myeloperoxidase protein (MPO) in archived serum samples.

RESULTS

Sensitivity of the granulocyte assay to predict FRD in dogs was 0.61 (95% confidence interval (CI), 0.45, 0.75), and specificity was 1.00 (95% CI, 0.91, 1.00). A significant association was identified between positive pANCA or cANCA result and diagnosis of FRD (P < 0.0001). Agreement between the two assays to detect ANCA in the same serum samples from SCWT with protein-losing enteropathy/protein-losing nephropathy (PLE/PLN) was substantial (kappa, 0.77; 95% CI, 0.53, 1.00). Eight ANCA-positive cases were positive for MPO or PR-3 antibodies.

CONCLUSIONS AND CLINICAL IMPORTANCE

The granulocyte immunofluorescence assay used in our pilot study was easy and quick to perform. Agreement with the previously published method was good.

The Radiochemical Analysis of Gaseous Samples (RAGS) apparatus for nuclear diagnostics at the National Ignition Facility (invited)

The Radiochemical Analysis of Gaseous Samples (RAGS) diagnostic apparatus was recently installed at the National Ignition Facility (NIF). Following a NIF shot, RAGS is used to pump the gas load from the NIF chamber for purification and isolation of the noble gases. After collection, the activated gaseous species are counted via gamma spectroscopy for measurement of the capsule areal density and fuel-ablator mix. Collection efficiency was determined by injecting a known amount of (135)Xe into the NIF chamber, which was then collected with RAGS. Commissioning was performed with an exploding pusher capsule filled with isotopically enriched (124)Xe and (126)Xe added to the DT gas fill. Activated xenon species were recovered post-shot and counted via gamma spectroscopy. Results from the collection and commissioning tests are presented. The performance of RAGS allows us to establish a noble gas collection method for measurement of noble gas species produced via neutron and charged particle reactions in a NIF capsule.

Evaluation of mucosal bacteria and histopathology, clinical disease activity and expression of Toll-like receptors in German shepherd dogs with chronic enteropathies

The pathogenesis of chronic enteropathies in dogs likely involves an interaction between the intestinal immune system and luminal intestinal bacteria. German shepherd dogs (GSD) are particularly predisposed to chronic enteropathies. The present study sought to evaluate expression patterns of certain pattern recognition receptors of the innate immunity (Toll-like receptors, TLR), clinical disease activity and histopathological severity in GSD with chronic enteropathies. Mucosal biopsies were collected from the duodenum, colon and ileum of 13 affected GSD and 10 healthy greyhounds as controls. Dogs were objectively assessed using published scoring systems for clinical and histological severity of disease. Diversity of the duodenal microbiota was assessed by construction of 16S rRNA gene libraries. Expression of TLR2, TLR4, TLR5 and TLR9 in biopsies of the duodenum, ileum and colon was assessed by quantitative real-time PCR. TLR4 expression was increased in all intestinal segments in GSD, however, TLR5 expression was very low compared to the healthy dogs. The microbiota in the duodenum of GSDs was significantly different to that of the greyhounds, with an over-representation of 16S rRNA gene sequences belonging to the classes of Bacilli, and Erysipelotrichi, and to the orders of Lactobacillales, Actinomycetales and Erysipelotrichales. These findings could point to a distinct pathogenesis of chronic enteropathies in GSD, with differentially high and low expression of TLR4 and TLR5, respectively, and increased proportions of specific members of the Lactobacillales potentially playing a role.

Expression of Toll-like receptor 2 in duodenal biopsies from dogs with inflammatory bowel disease is associated with severity of disease

There is growing evidence that aberrant innate immune responses towards the bacterial flora of the gut play a role in the pathogenesis of canine inflammatory bowel disease (IBD). Toll-like receptors (TLR) play an important role as primary sensors of invading pathogens and have gained significant attention in human IBD as differential expression and polymorphisms of certain TLR have been shown to occur in ulcerative colitis (UC) and Crohn's disease (CD). The aim of the current study was to evaluate the expression of two TLR important for recognition of commensals in the gut. TLR2 and TLR4 mRNA expression in duodenal biopsies from dogs with IBD was measured and correlated with clinical and histological disease severity. Endoscopic duodenal biopsies from 20 clinical cases and 7 healthy control dogs were used to extract mRNA. TLR2 and TLR4 mRNA expression was assessed using quantitative real-time PCR. TLR2 mRNA expression was significantly increased in the IBD dogs compared to controls, whereas TLR4 mRNA expression was similar in IBD and control cases. In addition, TLR2 mRNA expression was mildly correlated with clinical severity of disease, however, there was no correlation between TLR2 expression and histological severity of disease.

Epidemiology of subclinical dairy cow nematode infections on five farms in England in 2002 and a comparison with results from 1978 to 1979

A detailed study of the epidemiology of subclinical nematode infections in adult dairy cows was conducted on five well-managed English dairy farms during the 2002 grazing season. These same farms had also participated in a similar study in 1978-1979 and thus provided a unique opportunity to compare the epidemiological findings after an interval of over two decades. Common factors, including the prevalence of infection, faecal worm egg output, pasture larval count and nematode genera present, and estimated daily larval intake at pasture, were compared between the two studies. Subclinical roundworm burdens, as judged by faecal egg counts, were widespread in dairy cows in 2002, but the prevalence of animals with patent infections and the magnitude of the worm egg output were significantly lower than in 1978-1979. Both the prevalence of infection and mean faecal worm egg output exhibited a marked seasonal peak during the summer months in 2002. Pasture larval numbers were, however, nearly three times higher in 2002 with Ostertagia dominating the nematode genera to which cows were exposed at pasture in both surveys. Factors considered likely to account for differences in parasite epidemiology include the marked increase in herd productivity over the intervening period, the increased proportion of Holstein genetics with the consequent increase in milk yield and feed intake, changes in grassland management and increased stocking rate seen on the majority of farms.

Survey of flea infestation in dogs and cats in the United Kingdom during 2005

During 2005, 31 uk veterinary practices participated in a survey of flea infestation, during which 2653 dogs and 1508 cats were examined for evidence of flea infestation and skin disease compatible with flea allergy dermatitis (fad). The prevalence of flea infestation in the cats was 21.09 per cent, significantly (P<0.001) higher than in the dogs (6.82 per cent). The prevalence of skin lesions compatible with fad in the cats (8.02 per cent) was also significantly (P<0.001) higher than in the dogs (3.32 per cent). Flea infestations were more common in households with cats and with more than one pet. Of 467 fleas identified from the cats, 462 (98.93 per cent) were Ctenocephalides felis, one was Ctenocephalides canis, one was Archaeopsylla erinacei, two were Pulex irritans, and one was Spilopsyllus cuniculi. Of 336 fleas identified from the dogs, 313 (93.15 per cent) were C felis, five were C Canis, 12 were A erinacei, five were P irritans, and one was Ceratophyllus (Nosophyllus) fasciatus. Almost half of the owners of the dogs and cats were unaware of their pet's flea infestation. The overall prevalence of fleas and/or skin lesions that could potentially be compatible with fad was 7.46 per cent in the dogs and 22.28 per cent in the cats.

The implementation of first-trimester scanning at 10-13 weeks' gestation and the measurement of fetal nuchal translucency thickness in two maternity units

The aim of this prospective screening study was to evaluate the implementation of an additional ultrasound examination, incorporating the measurement of fetal nuchal translucency thickness, at 10-13 weeks' gestation in two maternity units providing routine antenatal care. During the 1 year prior to the introduction of the first-trimester scan, the major indication for fetal karyotyping was maternal age > or = 35 years and only two out of the total of 11 cases of trisomy 21 were identified. In the first 5 months of the study, 70% of the women delivering in these hospitals attended for measurement of fetal nuchal translucency thickness and the measurement was obtained in all cases. This was achieved without an increase in the number of sonographers or ultrasound machines. The incidence of fetal nuchal translucency thickness > or = 2.5 mm was 3.6% (63 of 1763), and this group included three of the four fetuses with trisomy 21. The findings of this study demonstrate the feasibility of introducing scanning at 10-13 weeks' gestation and the measurement of fetal nuchal translucency thickness in routine maternity units. The sensitivity and specificity of this method of screening are at present being evaluated in a large multicenter study.

Experience with peritoneal oocyte and sperm transfer as an outpatient-based treatment for infertility

Fifty-nine patients underwent 74 peritoneal oocyte and sperm transfer procedures. Forty-nine had previously failed treatment with inseminated frozen donor sperm and 10 had unexplained infertility. All procedures were carried out under ultrasound direction on an outpatient basis without general anesthetic by the transabdominal or vaginal route. Eighteen (24%) procedures resulted in pregnancy. Of these patients, 16 have delivered live infants (1 set of triplets, 2 twins, and 13 singletons) and 2 miscarried. Peritoneal oocyte and sperm transfer offers an outpatient-based alternative to gamete intrafallopian transfer (GIFT) for in vivo conception. It can also be used in patients scheduled for intrauterine insemination where stimulation is excessive because the number of oocytes replaced can be limited.

Kallmann's syndrome: reproductive success

Kallmann's syndrome is a genetic disorder that includes pituitary gonadotropin deficiency associated with sexual immaturity and infertility. A successful treatment program resulted in normalization of sexual development, spermatogenesis, and conception.

Studies on folliculogenesis and in vitro fertilization outcome after the administration of follicle-stimulating hormone at different times during the menstrual cycle

The authors have undertaken a prospective, randomized clinical trial of six treatments to optimize folliculogenesis in patients prior to oocyte collection, in vitro fertilization, and embryo transfer. All treatments involved the administration of the same daily dose of follicle-stimulating hormone (FSH), but at different times during the antecedent and/or current menstrual cycle. There was a significant difference (P less than 0.01, chi-square test) between treatments in the clinical pregnancy rate/patient (19 clinical pregnancies, 67 patients). No advantages were observed for regimens that involved starting treatment during the antecedent cycle. The study was continued with the three treatments that started during the current cycle (24 clinical pregnancies, 58 patients). The most cost-effective regimen was clomiphene citrate, 100 mg/day for days 2 to 6 inclusive; FSH, 150 units/day for days 1 to 4 inclusive; and human menopausal gonadotropin, 150 units/day from day 5 until the day of human chorionic gonadotropin administration.

An analysis of factors influencing the establishment of a clinical pregnancy in an ultrasound-based ambulatory in vitro fertilization program

In the study period (June 1984 to December 1986), 2232 cycles were stimulated in 1294 patients. Ultrasound-directed oocyte recovery (UDOR) was performed as an ambulatory procedure in 1737 (77.8%) cycles, resulting in 1375 embryos transfers (ET). Age, etiology, menstrual cycle length, number of oocytes collected, and number of embryos transferred were important determinants of the outcome. The number of attempts at in vitro fertilization did not affect the clinical pregnancy rate (CPR). In patients receiving four embryos, the CPR appeared to be highest when up to seven embryos were available for transfer. The fertilization rate in an individual cycle had a good prognostic value, the implantation rate being highest when 7 to 9 oocytes were retrieved and greater than 60% of these were fertilized. When 10 or more oocytes were collected, the implantation rate showed a progressive decline, regardless of the fertilization rate. Furthermore, multiple pregnancies failed to occur when greater than 12 oocytes were retrieved or more than eight embryos were available for transfer. These data suggest that, in excessively stimulated cycles, the quality of oocytes and embryos or uterine receptiveness may be suboptimal, and the transfer of more than four embryos is unlikely to increase the success rate.

The sequential use of a luteinizing hormone-releasing hormone (LH-RH) agonist and human menopausal gonadotropins to stimulate folliculogenesis in patients with resistant ovaries

The diagnostic response toward the administration of a luteinizing hormone-releasing hormone (LH-RH) analogue in the early follicular phase has been used sequentially with conventional human menopausal gonadotropin (hMG) treatment in patients who had previously failed to develop multiple follicles in response to a combination of hMG and clomiphene citrate. Nine of fourteen patients (64%) showed an increase in the number of preovulatory follicles and five subjects reached oocyte recovery for the first time. Two patients (22%) became pregnant after in vitro fertilization and embryo transfer during the treatment cycle and had healthy babies. It is suggested that this treatment regimen may be advantageous in some patients with resistant ovaries.

A comparison of treatments with exogenous FSH to promote folliculogenesis in patients with quiescent ovaries due to the continued administration of an LH-RH agonist

The circulating levels of plasma follicle-stimulating hormone (FSH), luteinizing hormone (LH) and oestradiol (E2) have been determined in three groups of three subjects during the continuous, subcutaneous administration of an LH-RH agonist (250 micrograms/day) and after the intramuscular injection of urinary FSH (group I, 150 IU daily for 8 days, total 1200 IU; group II, 300 IU on alternate days for four injections, total 1200 IU; and group III, 150 IU on alternate days for four injections, total 600 IU). The level of circulating FSH in group I rose steadily from a geometric mean of 1.11 (pre-injection) to 8.76 U/l (at day 8), while the corresponding levels in groups II and III fluctuated according to the time and dose of the injected material. Twenty-four hours after the injection the mean level of FSH in group II was significantly higher (7.31 U/l) than the corresponding value for group I (2.79 U/l) or group III (3.48 U/l). Only those subjects in group II showed a resumption of folliculogenesis (leading, mean maximum follicular diameters of 16, 13 and 14 mm, respectively) and a corresponding increase in the concentration of plasma E2 (from 22, 43 and 103 to 906, 1477 and 2362 pmol/l, respectively).

Ultrasound-guided peritoneal oocyte and sperm transfer

Peritoneal oocyte and sperm transfer (POST) was performed under ultrasound guidance and local anesthesia by the transabdominovesical route for a patient with unexplained infertility. This resulted in an intrauterine pregnancy confirmed by a raised beta-human chorionic gonadotropin (hCG) level and an ultrasound scan.

Studies on the measurement and pharmacodynamics of human follicle-stimulating hormone

The levels of immunoreactive follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), cortisol, and estradiol (E2) have been determined in serial samples of peripheral plasma from four subjects during the continuous, subcutaneous administration of Buserelin (Hoechst [UK] Ltd., Hounslow, UK) (250 micrograms/day) and after the intramuscular injection of purified, urinary FSH (Metrodin, Serono Laboratories [UK] Ltd., Welwyn Garden City, UK) (150 IU). During Buserelin administration the geometric mean levels of FSH and LH as measured by immunoradiometric assay were reduced by 87% and 37%, respectively, when compared with the corresponding values for days 1 and 2 of the menstrual cycle. After the intramuscular injection of FSH, peak levels (from 3.4 to 6.2 IU/l) occurred in peripheral plasma between 6 and 18 hours later. The levels were significantly elevated after 72 hours (P less than 0.01, Student's paired t-test). There was no obvious effect of the drugs on the circadian rhythms of plasma PRL or cortisol, and no significant effect on the circulatory levels of LH or E2.

Follicular aspiration using a syringe suction system may damage the zona pellucida

The incidence of the formation of cracks in the zona pellucida during aspiration was assessed by comparing two methods of aspirating follicular contents by suction: manual aspiration by syringe and mechanical aspiration by pump. Of 36 patients whose follicles were evacuated manually using syringes, 18 had at least one damaged oocyte. Of 38 other patients whose follicles were aspirated by pump, only one had an oocyte with a cracked zona pellucida. Four patients had their oocytes aspirated by both syringe and pump. In all four, the oocytes were intact when aspirated by the pump, but one oocyte was damaged in three of four cases when the follicles were aspirated using syringes.