Fatty acid fingerprints in bronchoalveolar lavage fluid and its extracellular vesicles reflect equine asthma severity

Equine asthma (EA) is an inflammatory disease of the lower airways driven by mediators released from cells. Extracellular vesicles (EVs) are vehicles for lipid mediators, which possess either pro-inflammatory or dual anti-inflammatory and pro-resolving functions. In this study, we investigated how the respiratory fatty acid (FA) profile reflects airway inflammatory status. The FA composition of bronchoalveolar lavage fluid (BALF), BALF supernatant, and bronchoalveolar EVs of healthy horses (n = 15) and horses with mild/moderate EA (n = 10) or severe EA (SEA, n = 5) was determined with gas chromatography and mass spectrometry. The FA profiles distinguished samples with different diagnoses in all sample types, yet they were insufficient to predict the health status of uncategorized samples. Different individual FAs were responsible for the discrimination of the diagnoses in different sample types. Particularly, in the EVs of SEA horses the proportions of palmitic acid (16:0) decreased and those of eicosapentaenoic acid (20:5n-3) increased, and all sample types of asthmatic horses had elevated dihomo-γ-linolenic acid (20:3n-6) proportions. The results suggest simultaneous pro-inflammatory and resolving actions of FAs and a potential role for EVs as vehicles for lipid mediators in asthma pathogenesis. EV lipid manifestations of EA can offer translational targets to study asthma pathophysiology and treatment options.

Isolation of Extracellular Vesicles From the Bronchoalveolar Lavage Fluid of Healthy and Asthmatic Horses

Extracellular vesicles (EVs) are membrane-bound particles that engage in inflammatory reactions by mediating cell–cell interactions. Previously, EVs have been isolated from the bronchoalveolar lavage fluid (BALF) of humans and rodents. The aim of this study was to investigate the number and size distribution of EVs in the BALF of asthmatic horses (EA, n = 35) and healthy horses (n = 19). Saline was injected during bronchoscopy to the right lung followed by manual aspiration. The retrieved BALF was centrifuged twice to remove cells and biological debris. The supernatant was concentrated and EVs were isolated using size-exclusion chromatography. Sample fractions were measured with nanoparticle tracking analysis (NTA) for particle number and size, and transmission electron microscopy and confocal laser scanning microscopy were used to visualize EVs. The described method was able to isolate and preserve EVs. The mean EV size was 247 ± 35 nm (SD) in the EA horses and 261 ± 47 nm in the controls by NTA. The mean concentration of EVs was 1.38 × 10¹² ± 1.42 × 10¹² particles/mL in the EA horses and 1.33 × 10¹² ± 1.07 × 10¹² particles/mL in the controls with no statistically significant differences between the groups. With Western blotting and microscopy, these particles were documented to associate with EV protein markers (CD63, TSG101, HSP70, EMMPRIN, and actin) and hyaluronan. Equine BALF is rich in EVs of various sizes, and the described protocol is usable for isolating EVs. In the future, the role of EVs can be studied in horses with airway inflammation.

Absorption of irrigating fluid during percutaneous transrenal lithotripsy

Twenty-eight patients who underwent percutaneous lithotripsy with isotonic mannitol solution as the irrigating fluid were studied. Intraoperative intravenous and total absorption of irrigating fluid was estimated from postoperative analyses of plasma and urinary concentrations of mannitol. Most operating times were short and only minor fluid absorption was recorded. In six cases, however, the fluid absorption exceeded 100 ml and two of these had a maximal calculated absorption of more than 1000 ml (1220 and 1860 ml, respectively). Intraoperative bleeding was a warning sign of absorption of irrigating fluid.

Duplex ultrasound in patients with suspected aorto-iliac occlusive disease

Duplex ultrasound scanning was used to localise and classify aorto-iliac occlusive disease. The study included 76 consecutive examinations of 73 patients with signs suggestive of proximal occlusive disease either by history or from traditional non-invasive laboratory investigation. Duplex ultrasound scanning indicated the presence of significant proximal occlusive disease in 70/101 limbs with suspected aorto-iliac disease. In total, 383/393 proximal arterial segments were assessed. A complete evaluation of the aorto-iliac region was possible in 91% of the patients. Duplex scanning was superior to oscillometric amplitude measurements and to CW Doppler examination, especially in patients with concomitant disease of the proximal superficial and deep femoral arteries. Duplex classification of stenoses correlated well with angiographic results obtained in 60 limbs with exact agreement in 194/211 (92%) arterial segments. Three of the patients with disparity between ultrasonography and angiography were investigated with intraarterial pressure measurements demonstrating that these lesions were underestimated by angiography. We conclude that Duplex ultrasound is feasible and accurate in detecting and grading lesions in the aorto-iliac region. This method provides important clinically useful haemodynamic information non-invasively in patients with suspected aorto-iliac occlusive disease.