A comparison of the release of phosphorus by a phytase enzyme in pigs fed diets deficient or adequate in phosphorus content

Previous research indicated that phytase may release less phosphorus (P) from phytate when it is evaluated using diets with P levels above requirement as compared with diets below requirement. The objectives of this experiment were to further test the hypothesis that the P release values determined for phytase are higher when pigs are fed diets that are deficient (DE) in P compared with when they are fed diets that are adequate (AD) in P, and that phytase will increase the digestibility of dry matter (DM), gross energy (GE), nitrogen (N), and calcium (Ca) independent of dietary P status. Twenty-four barrows (body weight: 23.2 ± 1.8 kg) were randomly assigned to one of eight dietary treatments and housed in individual pens for 21 d and then moved to metabolism crates for 9 d, with the collection of urine and feces occurring on the final 5 d. A basal corn-soybean meal diet (P-AD) was formulated at 0.36% standardized total tract digestible (STTD) P and total calcium:STTD P (Ca:STTD P) of 2:1. A P-DE diet was also formulated to maintain a constant Ca:STTD P of 2:1 in both basal diets. Phytase was added to AD and DE diets at 350, 600, 1,000 phytase units (FYT)/kg. Pig was the experimental unit; diet (P-AD or P-DE), phytase level, and replicate were fixed effects. Orthogonal polynomial contrasts were used to test linear and quadratic effects of phytase within P-AD and P-DE diets. Phytase improved apparent total tract digestibility (ATTD) and STTD of P in both P-AD (linear P < 0.001) and P-DE diets (quadratic P < 0.001). Estimates for STTD P release were 0.07%, 0.09%, and 0.09% for 350, 600, and 1,000 phytase units (FYT)/kg in P-DE diets, and 0.02%, 0.03%, and 0.05% in P-AD diets, respectively. In P-DE diets, phytase improved absorption and retention of P and increased urinary excretion of P (quadratic P < 0.001). In P-AD diets, phytase improved absorption of P (linear P = 0.066), tended to improve retention (linear P = 0.066), and increased urinary excretion of P (quadratic P = 0.021). Phytase improved ATTD of Ca in P-DE diets (quadratic P = 0.002) but not in P-AD diets (P > 0.1). In conclusion, the release of P by phytase is lower in diets that are AD in P than those which are DE. Phytase increased the availability of Ca only in the diets DE in P. Finally, phytase increased the ATTD of DM and tended to increase the ATTD of energy, independent of dietary P status.

Adverse effects on growth performance and bone development in nursery pigs fed diets marginally deficient in phosphorus with increasing calcium to available phosphorus ratios

The objective of this experiment was to evaluate the growth performance and bone mineral content (BMC) of nursery pigs in response to increasing total calcium (Ca) to available phosphorus (aP) ratios in diets containing phytase (250 FTU/kg; Natuphos E, BASF, Florham Park, NJ). A total of 480 nursery pigs (body weight (BW) = 5.7 ± 0.6 kg) with 10 pigs per pen and 7 pens per treatment (6 pens fed 2.75:1 diet) were allotted to seven treatments consisting of increasing ratios of calcium to available phosphorus (Ca:aP): 1.25, 1.50, 1.75, 2.00, 2.25, 2.50, and 2.75. From day −7 to 0, pigs were fed a common diet. They were then fed the treatment diets during two experimental phases from day 1 to 14 and 15 to 28, respectively. Available P was formulated to 0.33% and 0.27% (approximately 90% of requirement) in dietary phases 1 and 2, respectively. BW, average daily gain (ADG), average daily feed intake (ADFI), and gain-to-feed ratio (G:F) were determined. BMC of the femur was measured on day 28 on one pig per pen using dual x-ray absorptiometry. Data were analyzed as a linear mixed model using PROC MIXED (SAS, 9.3). Orthogonal polynomial contrasts were used to determine the linear and quadratic effects of increasing the Ca:aP. Over the 28-d experimental period, increasing Ca:aP resulted in a linear decrease in ADG (353, 338, 328, 304, 317, 291, and 280 g/d; P < 0.01), ADFI (539, 528, 528, 500, 533, 512, and 489 g/d; P < 0.05), and G:F (0.68, 0.66, 0.64, 0.62, 0.61, 0.59, and 0.58; P < 0.01). Increasing Ca:aP also resulted in decreased BW on days 14 and 28 (P < 0.01). The BMC of the femur decreased with increasing Ca:aP (6.2, 6.3, 5.7, 5.9, 5.5, 5.6, and 5.3 g; P < 0.05). Regression analysis explained the impact of Ca:aP as follows on ADG (ADG [g/d] = 339 − 36x; r² = 0.81), G:F (G:F = 0.61 – 0.03x; r² = 0.72), and BMC (BMC [g] = 6.4 – 0.27x; r² = 0.43), where x is the Ca:aP. In conclusion, all outcomes indicated that any level of calcium above the minimum used in this experiment impaired growth performance and skeletal development. Further research using even lower levels of dietary Ca is warranted.

Effects of an F18 enterotoxigenic Escherichia coli challenge on growth performance, immunological status, and gastrointestinal structure of weaned pigs and the potential protective effect of direct-fed microbial blends

The objective of this experiment was to investigate the impact of an F18 enterotoxigenic Escherichia coli (ETEC) challenge on growth performance, aspects of intestinal function, and selected immune responses of piglets, as well as to evaluate potential protective effects of direct-fed microbial (DFM) blends. Seventy-two weaned piglets (6.4 ± 0.2 kg body weight [BW]; ~21 d of age) were assigned to one of four treatments: 1) NC: Nonchallenged (n = 10), 2) positive challenged control (PC): F18 ETEC-challenged (n = 10), 3) PC + DFM1 (n = 8; three strains of Bacillus amyloliquefaciens; 7.5 × 10⁵ colony-forming units [cfu]/g), or 4) PC + DFM2 (n=8; 2 strains of B. amyloliquefaciens and one strain of Bacillus subtilis; 1.5 × 10⁵ cfu/g). Feed intake and BW were recorded on day 0, 7, and 17. Pigs were sham-infected either with 6 mL phosphate-buffered saline or inoculated with 6 mL F18 ETEC (~1.9 × 10⁹ cfu/mL) on day 7 (0 d postinoculation [dpi]). All ETEC-challenged pigs were confirmed to be genetically susceptible to F18. Pigs had ad libitum access to feed and water throughout the 17-d trial. Fecal scores were visually ranked and rectal temperatures were recorded daily. To evaluate ETEC shedding, fecal swabs were collected on dpi 0, 1, 2, 3, 5, 7, and 10. Blood samples were collected on dpi 0, 1, 2, 4, 7, and 10. Ileal tissues were collected at necropsy on dpi 10. All challenged treatments had lower final BW, decreased average daily gain (ADG), and average daily feed intake (ADFI) during the 10-d postchallenge period (P < 0.01). The DFM2 treatment increased E. coli shedding on dpi 2 and decreased iton dpi 7 (P < 0.05) compared with the PC. Rectal temperature decreased across all challenged treatments (P < 0.01). Ileal mRNA abundance of occludin (OCLN) and zonula occludens-1 (ZO-1) decreased in PC and DFM1 compared with NC (P < 0.05). Pigs fed DFM2 had intermediate ileal mRNA abundance of OCLN and increased ZO-1 mRNA compared with pigs in PC (P < 0.05). Interleukin 8 (IL-8) increased in the plasma of PC and DFM2 on dpi 2 compared with NC (P < 0.05). Mucosal IL-8 increased in PC compared with NC (P < 0.05). All challenged treatments tended to have elevated tumor necrosis factor-α (TNF-α) mRNA abundance compared with NC (P < 0.10). Challenged pigs had reduced secretory immunoglobulin A and villus height compared with NC pigs (P < 0.05). The impact of an ETEC challenge on intestinal function and the immune system has been revealed, information critical to developing improved treatment regimes.

Bioavailability of l-lysine sulfate relative to l-lysine HCl for growing-finishing pigs

The objective of this study was to evaluate the relative bioavailability (RBV) of l-Lys sulfate in comparison to l-Lys HCl based on the growth performance response from approximately 26 to 48 kg and from approximately 68 to 114 kg. The effect of Lys source on blood urea nitrogen (BUN), digestibility of dry matter (DM) and sulfur (S), as well as carcass characteristics was determined. A total of 280 growing pigs (25.9 ± 0.25 kg BW) were randomly assigned to one of seven dietary treatments in 56 pens, with five pigs per pen. The diets included a Lys-deficient basal diet (65% of requirement) and the basal diet supplemented with three graded levels of Lys (75%, 85%, and 95% of requirement), as either l-Lys HCl (78.8% Lys purity) or l-Lys sulfate (54.6% Lys purity). The experiment lasted for 112 d, with four dietary phases: Phase 1 lasted for 4 wk (BW: 25.9 to 47.5 kg), Phase 2 lasted for 3 wk (common commercial diet as washout period), Phase 3 lasted for 5 wk (BW: 67.5 to 98.2 kg), and Phase 4 lasted for 3 or 4 wk to reach an average market weight of 114.2 kg. Fresh fecal samples of pigs fed the highest levels of Lys (both Lys sources) were collected on 7 to 10 days after the beginning of Phase 3 for digestibility assay. Blood samples were collected on day 21 and day 81 to determine BUN. Carcass data were collected at a commercial packing plant. Data were analyzed using PROC GLM of SAS (9.4) according to a completely randomized design with pen as the experimental unit. The RBV of l-Lys sulfate was determined using the multiple regression slope-ratio method. Increasing levels of Lys, independent of source, increased (P < 0.05) BW, ADG, and feed efficiency during Phases 1, 3, and 4; market BW increased linearly (P < 0.01) and backfat and BUN decreased linearly (P < 0.01). Lysine source had no impact on growth performance, carcass characteristics, BUN, or digestibility of S and DM. The RBV of l-Lys sulfate compared with l-Lys HCl was also not different based upon ADG or G:F during Phase 1, 3, or 4. These data suggest that the bioavailability of Lys in l-Lys sulfate and l-Lys HCl is at least equivalent for growing–finishing pigs.

The impact of porcine spray-dried plasma protein and dried egg protein harvested from hyper-immunized hens, provided in the presence or absence of subtherapeutic levels of antibiotics in the feed, on growth and indicators of intestinal function and physiology of nursery pigs

The objective of this experiment was to compare the effects of spray-dried plasma protein (SDPP) and dried egg protein (DEP), without (AB-) or with (AB+) in-feed antibiotics, on growth performance and markers of intestinal health in nursery pigs raised in commercial conditions. This 42-d experiment utilized 1,230 pigs (4.93 ± 0.04 kg body weight; approximately 15-18 d of age). Pigs were randomly assigned to one of six dietary treatments that were arranged as a 2 × 3 factorial of in-feed antibiotics (AB- vs. AB+) and a specialty protein additive (none [CON], porcine SDPP, or DEP). Diets were fed in four phases with phases 3 and 4 as a common diet across all treatments. Specialty protein additives were fed in phases 1 (0-13 d; 3% SDPP, and 0.20% DEP) and 2 (13-26 d; 2% SDPP, and 0.10% DEP). Antibiotics were fed in phases 1-3 (662 mg chlortetracycline [CTC]/kg, 28 mg carbadox/kg, and 441 mg CTC/kg, respectively). Ileal tissue and blood samples were collected from 48 pigs (8 per treatment) on d 20. Data were analyzed using PROC MIXED of SAS (9.4) with pen as the experimental unit; protein additives, antibiotics, and their interaction were fixed effects and block was a random effect. The pigs experienced naturally occurring health challenges in weeks 2 and 4. In the AB- diets, SDPP and DEP increased average daily gain (ADG; P = 0.036) and average daily feed intake (ADFI; P = 0.040) compared to CON; in the AB+ diets, neither SDPP nor DEP increased ADG or ADFI compared to CON but SDPP did increase these parameters over DEP. The SDPP and DEP diets decreased the number of individual medical treatments compared to CON (P = 0.001). The AB+ increased ileal mucosal interleukin (IL)-1 receptor antagonist (P = 0.017). Feeding DEP reduced the concentration of mucosal IL-1β compared to CON, but not SDPP (P = 0.022). There was a trend for SDPP and DEP to increase villus height:crypt depth compared to CON (P = 0.066). Neither antibiotics or protein additive affected serum malondialdehyde concentration or ileal mRNA abundance of claudin-3 or 4, occludin, or zonula occludens-1 (P > 0.10). In conclusion, SDPP and DEP improved growth performance of weaned pigs in the absence of antibiotics but neither improved growth compared to CON when feeding standard antibiotic levels. The specialty proteins had a positive effect on health; specialty proteins and antibiotics were able to modulate some markers of intestinal inflammation and morphology.

Can the digestibility of corn distillers dried grains with solubles fed to pigs at two stages of growth be enhanced through management of particle size using a hammermill or a roller mill?

The objective of this study was to determine the impact of reducing the mean particle size (PS) of corn distillers dried grains with solubles (DDGS) with a hammermill (HM) or with a roller mill (RM) on the apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), N, acid hydrolyzed ether extract (AEE), and fiber components in growing and finishing pigs. Twenty-four growing barrows were housed in individual pens and were randomly assigned to a 3 × 2 factorial design (n = 8): three grinding methods [either corn DDGS ground with an HM to a PS of 450 μm; corn DDGS ground with an RM to a PS of 450 μm; and corn DDGS with a PS of 670 μm (not further ground)] and two body weight (BW) periods (growing pigs with an average initial BW of 54.7 ± 0.9 kg, and finishing pigs with an average initial BW of 107.8 ± 1.5 kg BW). Fecal samples were collected for each BW period in the last 3 d of an 11-d feeding period. Titanium dioxide was used as an indigestible marker. Digestibility data were analyzed using the MIXED procedure of SAS. Results showed that finishing pigs tended to have better ATTD of DM than growing pigs (P = 0.09) and had increased ATTD of GE and N than growing pigs (P = 0.03 and P < 0.01, respectively). On the other hand, growing pigs had better ATTD of AEE than finishing pigs (P = 0.01). Pig BW period did not affect the ATTD of neutral detergent fiber (NDF), acid detergent fiber (ADF), and hemicellulose. Reducing the mean PS of corn DDGS with either HM or RM (from 670 to 450 µm) improved the ATTD of DM and GE (P < 0.01 and P < 0.01), tended to improve the ATTD of N (P = 0.08), and improved the ATTD of AEE (P < 0.01). No effect of reducing PS was observed for the ATTD of NDF, ADF, or hemicellulose. There were no differences between HM and RM in any of the ATTD variables tested. In conclusion, reducing PS of corn DDGS from 670 to 450 μm either with an HM or with an RM improved the digestibility of DM, GE, and AEE and modestly improved the digestibility of N in growing and finishing pigs. However, reducing the PS of corn DDGS did not affect the digestibility of fiber components.

The effects of enzymatically treated soybean meal on growth performance and intestinal structure, barrier integrity, inflammation, oxidative status, and volatile fatty acid production of nursery pigs

The objective of this experiment was to determine the impact of diets containing increasing amounts of enzymatically treated soybean meal (ESBM) but decreasing amounts of soybean meal (SBM) on growth performance, intestinal structure, and barrier integrity, inflammation, and oxidative status in weaned pigs. A total of 480 pigs [6.3 ± 1.2 kg body weight (BW)] were blocked by initial BW and pens (n = 12 per treatment) were randomly allotted to one of four dietary treatments. Diets were fed in three phases (days 0-14, 14-28, and 28-35) over a 35-d period. The four dietary treatments consisted of a negative control diet (NC): the NC with 7.0% ESBM (ESBM1), the NC with 14.0% ESBM (ESBM2), and the NC with 21.0% ESBM (ESBM3). Soybean meal was reduced proportionately in each treatment. In phase 2, ESBM inclusion was decreased by 50% (3.5%, 7.0%, and 10.5% ESBM, respectively); phase 3 was a common diet and contained no ESBM. Fecal score was visually ranked weekly using a four-point scale. Intestinal tissue, digesta, and blood samples were collected from 48 pigs (1 per pen) on day 10. Data were analyzed using PROC MIXED of SAS (9.4) with pen as the experimental unit; diet and block were considered fixed effects. Linear and quadratic contrasts were used to determine the effect of increasing ESBM. Overall, ESBM2 and ESBM3 decreased final BW, average daily gain, and average daily feed intake compared to NC and ESBM1 (diet, P < 0.05; linear, P < 0.05). Overall fecal score (diet, P < 0.05) and fecal dry matter (P < 0.05) were improved by feeding ESBM diets compared to NC. Volatile fatty acid (VFA) concentration of acetate, propionate, butyrate, and total VFA in ileal contents increased as ESBM inclusion increased (P < 0.05). Colonic VFA concentration was not impacted (P > 0.10). Total antioxidant capacity was increased by ESBM (P < 0.05). The concentration of mucosal interleukin-4 increased as the inclusion of ESBM increased (linear, P < 0.05). Messenger ribonucleic acid abundance of occludin and zonula-occludens-1 in ileal tissue was increased by ESBM1 or ESBM2 (P < 0.05). In conclusion, increasing the dietary levels of ESBM over 7% had a negative impact on nursery pig performance, but ESBM positively impacted fecal score. Feeding ESBM improved oxidative status and intestinal barrier integrity while increasing ileal VFA production but had minimal impact on intestinal inflammation or morphology. Further research is needed to determine the optimal inclusion level of ESBM.

Dietary Soluble and Insoluble Fiber With or Without Enzymes Altered the Intestinal Microbiota in Weaned Pigs Challenged With Enterotoxigenic E. coli F18

Post-weaning diarrhea caused by enterotoxigenic E. coli (ETEC) causes significant economic losses for pig producers. This study was to test the hypotheses that an ETEC challenge disrupts intestinal microbial homeostasis and the inclusion of dietary soluble (10% sugar beet pulp) or insoluble fiber (15% corn distillers dried grains with solubles) with or without exogenous carbohydrases will protect or restore the gut microbial homeostasis in weaned pigs. Sixty crossbred piglets (6.9 ± 0.1 kg) were blocked by body weight and randomly assigned to one of six treatments (n = 10), including a non-challenged control (NC), ETEC F18-challenged positive control (PC), ETEC-challenged soluble fiber without (SF-) or with carbohydrases (SF+), and ETEC-challenged insoluble fiber without (IF-) or with carbohydrases (IF+). Pigs were housed individually and orally received either ETEC inoculum or PBS-sham inoculum on day 7 post-weaning. Intestinal contents were collected on day 14 or 15. The V4 region of the bacterial 16S rRNA was amplified and sequenced. High-quality reads (total 6,671,739) were selected and clustered into 3,330 OTUs. No differences were observed in α-diversity among treatments. The ileal microbiota in NC and PC had modest separation in the weighted PCoA plot; the microbial structures were slightly altered by SF+ and IF- compared with PC. The PC increased ileal Escherichia-Shigella (P < 0.01) and numerically decreased Lactobacillus compared to NC. Predicted functional pathways enriched in the ileal microbiota of PC pigs indicated enhanced activity of Gram-negative bacteria, in agreement with increased Escherichia-Shigella. The SF+ tended to decrease (P < 0.10) ileal Escherichia-Shigella compared to PC. Greater abundance of ileal Streptococcus, Turicibacter, and Roseburia and colonic Prevotella were observed in SF- and SF+ than PC (P < 0.05). Pigs fed IF + had greater Lactobacillus and Roseburia than PC pigs (P < 0.05). The ETEC challenge reduced total volatile fatty acid (VFA) compared with NC (P < 0.05). The SF+ tended to increase (P < 0.10) and SF- significantly increased (P < 0.05) colonic total VFA compared with PC. Collectively, ETEC challenge disrupted gut microbial homeostasis and impaired microbial fermentation capacity. Soluble fiber improved VFA production. Dietary fiber and carbohydrases altered microbiota composition to maintain or restore microbial homeostasis.

Effects of grinding method and particle size of wheat grain on energy and nutrient digestibility in growing and finishing pigs

Feed grains are processed to improve their value in pig diets by exposing kernel contents to enzymatic and microbial action. The objective of this study was to quantify the effect of reducing mean particle size (PS) of wheat grain ground with two different grinding methods (GMs) on the apparent total tract digestibility (ATTD) of nutrients and energy in growing and finishing pigs. Forty-eight barrows were housed in individual pens for 11 d for two periods. Pigs were randomly assigned to a 3 × 2 × 2 factorial experimental design: three target mean PS of wheat grain (300, 500, and 700 µm), two GMs (roller mill and hammermill), and two body weight (BW) periods (growing period; initial BW of 54.9 ± 0.6 kg and finishing period; initial BW of 110.7 ± 1.4 kg). Diets contained one of six hard red wheat grain samples, vitamins, minerals, and titanium dioxide as an indigestible marker. Feed allowance provided 2.5 (for the two lightest pigs in each treatment) or 2.7 (for the remaining six pigs in each treatment) times the estimated daily maintenance energy requirement for each growth stage. Fecal samples were collected for the last 3 d of each period. Data were analyzed as a linear mixed model with pig as a random effect and PS, GM, and BW period and their interactions as fixed effects utilizing the MIXED procedure of SAS. Growing pigs had greater (P < 0.05) ATTD of dry matter (DM), gross energy (GE), N, acid hydrolyzed ether extract (AEE), and neutral detergent fiber (NDF) by lowering mean PS from 700 to 500 μm using either a roller mill or a hammermill. However, digestibility did not increase when PS was reduced from 500 to 300 μm, except for AEE (P < 0.05). Finishing pigs had greater ATTD of DM, GE, N, AEE, and NDF by lowering mean PS with a hammermill from 700 to 500 μm (P < 0.05), but it was greater for 500 μm than for 300 μm (P < 0.05). Using a roller mill reduced the ATTD of DM and NDF by lowering PS from 700 to 300 μm (P < 0.05). The ATTD of GE decreased by lowering PS from 700 to 500 μm with a roller mill (P < 0.05) for finishing pigs. The ATTD of N and AEE for finishing pigs were similar from 700 to 300 μm when ground by a roller mill. These data suggest that the PS that maximized digestibility for a hammermill is 500 μm for both growing and finishing pigs. However, for the roller mill, the PS resulting in the best digestibility were 500 and 700 μm for growing and finishing pigs, respectively.

Evaluation of the effect of β-mannanase supplementation and mannans on nursery pig growth performance and serum acute-phase protein concentrations

The objective was to evaluate the effects of dietary mannan and β-mannanase supplementation on growth performance and serum acute-phase proteins in nursery pigs. Pigs (n = 480) were blocked by initial body weight (6.6 ± 0.4 kg), and 12 pens per treatment were randomly assigned to one of four treatments in a 2 × 2 factorial arrangement for 28 d. Two levels of dietary mannan (0.4% vs. 2.8%) were offered with and without 0.05% endo-1,4-β-mannanase. Serum was collected (one pig per pen) for haptoglobin and C-reactive protein (CRP) analysis on days 0 and 28. There were no significant interactions between mannan level and β-mannanase supplementation. High-mannan diet decreased average daily gain (P = 0.027) and average daily feed intake (P = 0.024) compared with low-mannan diets with no effect of β-mannanase (P > 0.10). Haptoglobin and CRP were not affected by mannan level or β-mannanase supplementation (P ≥ 0.160). Therefore, dietary β-mannans as high as 2.8% did not induce a systemic innate immune response. Thus, the levels of β-mannan found in practical diets (<2%) are unlikely to induce an immune response; therefore, supplementation of β-mannanase to avoid this response is not warranted.

Enhancing digestibility of corn fed to pigs at two stages of growth through management of particle size using a hammermill or a roller mill

The experimental objective was to determine the role of mean particle size (PS), grinding method, and body weight (BW) category on nutrient, fiber, and energy digestibility of corn. A total of 48 barrows were housed in individual pens and randomly assigned to one of six dietary treatments for 11 d at two BW categories (55 kg and 110 kg). The six treatments consisted of corn ground at three different targeted mean PSs (300, 500, and 700 µm) using either a roller mill or a hammermill. Fecal samples were collected for the last 3 d of each feeding period. Titanium dioxide was used as an indigestible marker. Digestibility data were analyzed as a linear mixed model using the MIXED procedure of SAS. Finishing pigs had greater apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), and N than growing pigs (P = 0.02, P = 0.01, and P <0.01, respectively). The ATTD of DM, GE, and N was similar in pigs fed hammermilled corn across all PS treatments. However, in roller-milled corn, they increased as PS was reduced (P < 0.05). The ATTD of acid-hydrolyzed ether extract (AEE) in growing pigs was similar between corn ground at 700 and 500 µm, but it was increased by further reducing PS to 300 µm (P < 0.05). In finishing pigs, the ATTD of AEE increased as mean PS decreased from 700 to 300 µm (P < 0.05). The ATTD of AEE was similar in hammermilled corn at all three PS treatments. On the other hand, the ATTD of AEE was similar in corn ground in a roller mill to 700 and 500 µm, but it increased when PS was reduced to 300 µm (P < 0.05). In conclusion, reducing PS of corn with a roller mill increased digestibility of energy and nutrients, but there was less effect using a hammermill. It is possible that differences in SD, distribution, chemical composition, and the shape of the particles resulting from the two grinding processes help to explain the different response.

175 Effects of increasing calcium to available phosphorus ratios in diets containing phytase on growth performance and bone mineral content of nursery pigs

The objective of this experiment was to evaluate the growth performance of nursery pigs in response to increasing total calcium to available phosphorus (aP) ratios in diets containing phytase (250 FTU/kg, Natuphos E, BASF, Florham Park, NJ). A total of 480 nursery pigs (BW=5.74 ± 0.62 kg; L337 X Camborough, PIC, Hendersonville, TN) with 10 pigs/pen and 7 pens per treatment (6 pens fed 2.75:1 diet) were allotted to 7 treatments consisting of increasing ratios of calcium to available phosphorus: 1.25, 1.50, 1.75, 2.00, 2.25, 2.50, 2.75. From d-7–0, pigs were fed a common diet. They were then fed the treatment diets during two experimental phases from d1–14, and d15–28, respectively. Available P was formulated to 0.33 and 0.27% (about 90% of requirement) in dietary phases 1 and 2, respectively. Body weight, ADG, ADF and G:F were determined. Mineral content of the femur was measured on d 35 on 1 pig per pen using DXA procedures. Data were analyzed as repeated measures using PROC MIXED (SAS, 9.3). Orthogonal polynomial contrasts were used to determine linear and quadratic effects of increasing the Ca:aP ratio. Increasing Ca:aP resulted in a linear decrease in ADG (353, 338, 328, 304, 317, 291, 280 g/d; P < 0.01), ADFI (539, 528, 528, 500, 533, 512, 489 g/d; P < 0.05) and G:F (0.68, 0.66, 0.64, 0.62, 0.61, 0.59, 0.58; P < 0.01). Increasing Ca:aP also resulted in decreased BW on days 14 and 28 (P < 0.01). Bone mineral content (BMC) decreased with increasing Ca:aP ratio (6.2, 6.3, 5.7, 5.9, 5.5, 5.6, 5.3 g; P < 0.05). In conclusion, all outcomes indicated that any level of calcium above the minimum used in this experiment impaired growth performance and skeletal development. Additional, longer term studies are required as these results were unexpected.

159 Impact of dietary fiber and carbohydrases on intestinal gene transcription in enterotoxigenic E. coli challenged pigs

This study aimed to evaluate if soluble (10% sugar beet pulp) or insoluble dietary fiber (15% corn DDGS) with or without exogenous carbohydrases protect piglets against enterotoxigenic E. coli (ETEC)-induced changes in gene transcription of markers of intestinal inflammation and barrier integrity. Sixty newly-weaned piglets (BW=6.9 ± 0.1 kg; L337 X Camborough, PIC, Hendersonville, TN) were blocked by initial BW, preselected for F18 ETEC sensitivity and placed in individual pens. Pens were randomly assigned to 1 of 6 treatments (n = 10/trt): non-challenged (NC), ETEC-challenged (PC), PC-fed a soluble fiber diet without (SF-) or with (SF+) carbohydrases (xylanase, β-glucanase, and pectinase), or PC fed an insoluble fiber diet without (IF-) or with carbohydrases (IF+). Pigs were orally inoculated with ETEC or PBS on d 7 post-weaning. Intestinal tissues were collected on d 14 or 15. Data were analyzed using PROC GLIMMIX (SAS 9.4); treatment was a fixed effect and block a random effect. The NC decreased interleukin (IL)-8 and increased claudin-1 (CLDN1; 2.32 vs. 0.96) mRNA abundance in the ileum compared to PC (P < 0.05). The SF- increased ileal CLDN1 mRNA compared to PC (P < 0.05). A trend (P < 0.10) for lower levels of tumor necrosis factor alpha (TNFα) and greater occludin (OCLN) mRNA in the ileum was observed in SF+ compared with PC. The IF+ decreased ileal cluster of differentiation 14 (CD14) mRNA abundance compared to PC (P < 0.05). Greater colonic abundance of zonula occludens (ZO-1) mRNA was observed in NC than PC (P < 0.05). Pigs fed SF+ tended (P = 0.051) to have greater ZO-1 and greater OCLN mRNA abundance than pigs on PC (P < 0.05). Collectively, these data suggest that an ETEC challenge increased markers of gut inflammation and reduced mRNA levels of tight junction proteins. Soluble fiber, regardless of enzyme supplementation, may help improve gut barrier integrity during such a challenge.

A soluble and highly fermentable dietary fiber with carbohydrases improved gut barrier integrity markers and growth performance in F18 ETEC challenged pigs1

This study aimed to evaluate the effects of a source of dietary soluble (SF) and insoluble fiber (IF) without or with exogenous carbohydrases (xylanase, β-glucanase, and pectinase) on diarrhea incidence, selected immune responses, and growth performance in enterotoxigenic Escherichia coli (ETEC)-challenged pigs. Sixty weaned pigs (6.9 ± 0.1 kg BW, ~23 d of age) were blocked by initial BW and placed in individual pens. Pens were randomly assigned to one of six treatments (n = 10 per treatment), including a nonchallenged control (NC), a positive challenge control (PC), the PC + a soluble fiber diet (10% sugar beet pulp) without (SF-) or with carbohydrases (SF+), and PC + an IF diet (15% corn distillers dried grains with solubles) without (IF-) or with carbohydrases (IF+). The control diet was primarily based on corn and soybean meal with 13.5% whey powder. The two sources of fiber were added at the expense of cornstarch in the control diet. Pigs were orally inoculated with 6 mL hemolytic F18 ETEC (~3.5 × 109 cfu/mL) or sham infected with 6 mL phosphate-buffered saline on day 7 (0 d postinoculation, dpi) postweaning. All ETEC challenged pigs were confirmed to be genetically susceptible to F18 ETEC. Pigs had free access to feed and water throughout the 14-d trial. Pig BW and feed intake were recorded on dpi -7, 0, and 7 or 8. Fecal swabs were collected on dpi -7, 0, 1, 2, 3, 5, and 7 or 8 to evaluate hemolytic E. coli shedding. Fecal score was visually ranked daily postchallenge to evaluate diarrhea incidence. Blood samples were collected on dpi -1, 3, and 7 or 8 at necropsy and intestinal tissues were collected at necropsy. Pigs on PC had lower dpi 1 to 7 ADG and ADFI than those on NC (P < 0.05). Compared with PC pigs, SF+ pigs had greater ADG during both pre- and postchallenge period (P < 0.05). The IF- increased postchallenge diarrhea incidence compared with PC (P < 0.05). Pigs on SF- had lower ileal E. coli attachment than PC (P < 0.05). The SF+ reduced haptoglobin and IF+ reduced C-reactive protein on dpi 3 compared with PC (P < 0.05). Compared with PC pigs, SF+ pigs tended to have lower ileal tumor necrosis factor alpha and greater ileal occludin (OCLN) mRNA (P < 0.10) and had greater (P < 0.05) colonic OCLN mRNA levels. Collectively, IF- increased incidence of diarrhea and fecal E. coli shedding compared with PC. The SF+ pigs had improved growth compared with PC pigs, likely due in part to a reduction in inflammatory intermediates.

Evaluating phosphorus release by phytase in diets fed to growing pigs that are not deficient in phosphorus

Microbial phytase is widely used to enhance digestibility of phytate-P. By tradition, diets with P content well below requirement are used to quantify phytate-P release by phytase, but P-adequate diets may be more physiologically relevant. The objective of this study was to investigate the effects of phytase on P digestion and metabolism and develop a P release curve for phytase in P-adequate diets (above requirement according to NRC, 2012), and to compare these effects in a P-deficient diet. Three replicates of 24 barrows each (BW = 23.0 ± 1.8 kg) were randomly assigned to 1 of 8 dietary treatments, housed in individual pens for 21 d, then moved to metabolism crates for 5 d urine and fecal collections. A basal corn-soybean meal diet (P-adequate, A) was formulated at 0.36% standardized total tract digestible (STTD) P and total Ca:STTD P of 1.83. Phytase was added to A at 200 (A200), 400 (A400), 600 (A600), and 800 (A800) phytase units (FTU)/kg. A positive control diet (PC) was formulated using monocalcium phosphate (MCP) to increase STTD P by 0.16% to 0.52%, the expected STTD P release of 800 FTU/kg. A P-deficient diet (D) was formulated by reducing MCP to achieve 0.21% STTD P, and 200 FTU phytase/kg was added to D for D200. Pig was the experimental unit, and replicate and dietary treatment were fixed effects. Orthogonal polynomial contrasts were used to test linear and quadratic effects of phytase within A, A200, A400, A600, and A800. Phytase increased percent apparent total tract digestibility (ATTD) and STTD of P (quadratic P < 0.001), and quantity of absorbed P (linear P < 0.001; quadratic P = 0.069). Urinary P increased linearly with phytase (P < 0.001) and retained P also increased (linear P = 0.001, quadratic P = 0.094). Phytate-P release was estimated to be 0.049, 0.080, 0.093, and 0.09% STTD P for 200, 400, 600, and 800 FTU/kg, respectively. It appears that the effect of phytase may be lower in P-adequate diets as compared to P-deficient diets, given that there was a 12% improvement for A200 versus A, and a 28% improvement in STTD P for D200 versus D. In conclusion, phytase improved P digestibility and retention in P-adequate diets, and P digestibility was used to estimate the quantity of P released by phytase. Further research investigating P release by phytase in P-adequate diets, rather than P-deficient diets, may be preferable.

Exogenous carbohydrases added to a starter diet reduced markers of systemic immune activation and decreased Lactobacillus in weaned pigs1

Although the impact of carbohydrases on performance and nutrient utilization has been well studied, their effects on immune status and intestinal microbiota are less known in pigs. This study aimed to evaluate the impact of xylanase (X) and a carbohydrase enzyme blend (EB; cellulase, ß-glucanase, and xylanase) on the immune profile of the intestine and peripheral system as well as intestinal microbes and microbial metabolites of weaned pigs fed higher fiber diets. Pigs (n = 460; 6.43 ± 0.06 kg BW; F25 × 6.0 Genetiporc) were blocked by initial BW. Pens (n = 48; 12 per treatment; 9 or 10 pigs per pen) were randomly assigned to 1 of 4 dietary treatments, including a higher fiber control diet (CON) and the CON supplemented with 0.01% X, 0.01% EB, or both enzymes (X + EB), arranged in a 2 × 2 factorial. The diets were based on corn, soybean meal, corn distillers dried grains with solubles, and wheat middlings. After 7-d adaptation to the environment, pigs were fed experimental diets ad libitum for 28 d. Blood samples were collected from the same pig within each pen on days 0, 7, 14, and 28. Intestinal tissues and digesta were collected on day 28. Bacteria 16S rRNA gene copy numbers were quantified using qPCR. The mRNA levels of colonic IL-17, occludin (OCLN), and claudin 3 (CLDN3) were greater in pigs fed diets with X + EB, but not X or EB, compared with those fed CON (P < 0.05). The EB in the diet reduced plasma IL-8 over the 28-d trial compared with diets without EB (P < 0.05). There was an X × EB interaction on plasma tumor necrosis factor α and IL-1ß (P < 0.05); their levels were decreased when X and EB were added together, but not individually, compared with CON. The EB decreased cecal propionate, butyrate, and total volatile fatty acids (P < 0.05). Pigs fed X had lower ileal Lactobacillus and greater ileal and cecal Enterobacteriaceae compared with those fed unsupplemented diets (P < 0.05). The EB decreased Lactobacillus (P < 0.05) and tended to decrease (P = 0.065) Enterobacteriaceae in the colon compared with diets without EB. In conclusion, the addition of X and EB together decreased systemic markers of immune activation, potentially diverting energy and nutrients towards growth. The EB reduced colonic Lactobacillus and cecal total volatile fatty acids, probably due to improved prececal fiber and starch degradation and thus reduced substrate availability in the large intestine. These data corroborated previously observed enhanced growth in pigs fed EB-supplemented diets.

The impact of "super-dosing" phytase in pig diets on growth performance during the nursery and grow-out periods

Previous research indicates that “super-dosing” phytase may improve pig growth performance by improved nutrient use, although the benefits appear to be more consistent in nursery than in grow-out pigs. Therefore, two experiments were conducted to determine if performance could be improved by feeding phytase at super-dosed levels, and whether this response would be different if energy and amino acid (AA) were limiting. Experiment 1 involved 440 weaned pigs (6.27 ± 0.01 kg) in a factorial arrangement of treatments comparing the main effects of diet (positive control [PC] balanced for all nutrients vs. a negative control [NC]: 10% lower standardized ileal digestible (SID) lysine with relative reduction of all other essential AA and 1% reduced fat) and phytase levels (0 vs. 2,500 FTU Quantum Blue 5G phytase/kg). Pigs were assigned to pen according to a randomized complete block design based on body weight (BW). Feed and water were provided ad libitum across four dietary phases: 3 × 1 wk plus 1 × 2 wk. The average daily gain (ADG) and gain to feed ratio (G:F) were improved in the PC relative to the NC (P < 0.05) indicating success in formulating a diet limiting in energy and/or AA. Phytase improved ADG and G:F, regardless of diet composition (P < 0.05). Thus, super-dosing phytase improved nursery pig growth performance, irrespective of diet nutrient adequacy or deficit. Experiment 2 involved 2,200 growing pigs (36.6 ± 0.30 kg) allotted to five treatments: a balanced PC (250 FTU Quantum Blue 5G phytase/kg), an NC (PC with 15% less SID lysine and 1.5% lower net energy [NE]), and three super-dosing phytase treatments applied to the NC totaling 1,000, 1,750, and 2,500 FTU phytase/kg. Feed and water were available ad libitum. At trial completion (approximately 122 kg), the PC pigs were heavier and more efficient than the NC pigs (P < 0.05) indicating success in formulating an NC treatment. Super-dosing phytase had no effect on whole body ADG or average daily feed intake (P > 0.10) but tended to improve G:F and feed energy efficiency (P < 0.10). Super-dosing phytase improved carcass-based feed and feed energy efficiency (P < 0.05) and tended to improve ADG (P < 0.10). Supplying phytase at “super-dosed” levels—above that required to meet the phosphorus requirement—improved growth performance in nursery pigs (6 to 22 kg BW) and provided smaller benefits in grow-finish pigs (37 to 122 kg BW). The improvement during the nursery period was independent of energy and AA levels in the diet.

A dietary carbohydrase blend improved intestinal barrier function and growth rate in weaned pigs fed higher fiber diets

The objective of this study was to evaluate the effects of dietary xylanase (X) and a carbohydrase enzyme blend (EB: cellulase, β-glucanase, and xylanase) on nutrient digestibility, intestinal barrier integrity, inflammatory status, and growth performance in weaned piglets fed higher fiber diets. A total of 460 pigs (6.43 ± 0.06 kg BW; F25 × 6.0 Genetiporc) were blocked by initial BW and pens (n = 12 per treatment) were randomly assigned to 1 of 4 dietary treatments. The diets included a higher fiber unsupplemented control diet (CON) and the CON supplemented with 0.01% X, 0.01% EB, or both enzymes, arranged in a 2 × 2 factorial. The diets were based on corn, soybean meal, corn distillers dried grains with solubles (DDGS), and wheat middlings. Pigs had 7 d to adapt to the environment and consumed the same commercial diet. Pigs were fed the experimental diets for 28 d with free access to feed and water. Body weight and feed disappearance were recorded weekly. One pig with BW closest to the pen average from each pen was selected and moved to metabolism crates on day 16 and intragastric gavaged a solution of lactulose and mannitol on day 22 followed by 12-h urine collection. Feces were collected from day 23 to 25. Intestinal tissues and mucosal scrapings were collected on day 28. Data were analyzed using PROC MIXED of SAS (9.4). Xylanase, EB, and their interaction were fixed effects and block was a random effect. The EB, but not X, increased pig BW and improved ADG over 28 d (P < 0.05). Neither carbohydrase impacted ADFI, G:F, or apparent total tract digestibility (ATTD) of DM, GE, or CP. The EB improved ATTD of ADF (32.45 vs. 26.57%; P < 0.01), but had no effect on NDF. Unexpectedly, X reduced ATTD of NDF and ADF (P < 0.01). The EB reduced urinary lactulose:mannitol and increased ileal claudin-3 mRNA abundance (P < 0.05), indicating improved small intestinal barrier integrity. There was a X × EB interaction on ileal secretory immunoglobulin A (sIgA) concentration (P < 0.05); in the absence of X, EB decreased sIgA compared to CON, but this effect disappeared in the presence of X. The EB also reduced ileal IL-22 mRNA abundance (P < 0.05), probably indicating decreased immune activation. In conclusion, EB but not X enhanced growth rate of weaned pigs fed higher fiber diets, which may be partly explained by the improved small intestinal barrier integrity and reduced immune activation, rather than improvement in nutrient digestibility.

Corneal sensitivity in healthy bovine calves

OBJECTIVE

To evaluate corneal sensitivity as measured by the corneal touch threshold in healthy bovine calves.

ANIMALS STUDIED

Twelve clinically normal male calves with predominantly Holstein genetics and a median age of 76.5 days (range, 67-92 days).

PROCEDURES

Corneal touch threshold (CTT) of the central cornea was measured in both eyes of each calf using a Cochet-Bonnet aesthesiometer.

RESULTS

The mean ± standard deviation corneal touch threshold of all eyes was 1.33 ± 1.1 g/mm(2) (range, 0.62-66.15 g/mm(2) ), corresponding to a filament length of 34.56 ± 8.02 mm (range, 14-47.5 mm). There was no significant difference between fellow eyes.

CONCLUSIONS

Cochet-Bonnet aesthesiometry was well tolerated in all 12 calves using a modified head restraint. Calves in this study may have a relatively sensitive central cornea compared to adult cattle and some other species; however, wide variation among individuals and eyes may be possible. Studies utilizing larger calf populations are necessary to establish reference ranges.

Evaluating approaches to measuring ocular pain in bovine calves with corneal scarification and infectious bovine keratoconjunctivitis-associated corneal ulcerations

Infectious bovine keratoconjunctivitis (IBK) is a common ocular disease in cattle, associated with a 6.8 to 13.6 kg decrease in weaning weight. Antibiotic therapy is available but it is unclear if pain mitigation as an adjunct therapy would reduce the weight loss associated with IBK. Before assessing the impact of pain mitigation therapies, it is first necessary to validate approaches to qualifying ocular pain. The objective of this study was to evaluate approaches to qualifying ocular pain in bovine calves (Bos taurus) with IBK. Our a priori assumption was that scarification or corneal ulcerations consistent with IBK are painful compared to normal eyes. To quantify this difference in pain, we assessed 4 tools: pressure algometry-mechanical nociceptive threshold (PA-MNT), corneal touch thresholds (CTT) obtained with the use of a Cochet-Bonnet aesthesiometer, and assessment for the presence of blepharospasm and photophobia as metrics for pain. Using a 1-eye randomized controlled challenge trial, 31 calves with healthy eyes were randomly allocated to treatment groups, and then a left or right eye was randomly assigned for corneal scarification and inoculation with Moraxella bovoculi or Moraxella bovis. A repeated measures analysis of variance was used for PA-MNT, with significance set at P < 0.05. A log (base 10) transformation was used to stabilize the variance, and Tukey's t tests were used to test differences between assessment days for each landmark. Calves had statistically significantly lower PA-MNT scores (which indicates more pain) the day after scarification relative to baseline measurements (4 d before scarification). For example, at 1 landmark the median PA-MNT (kg/force) prescarification was 4.82 (95% confidence interval [CI]: 3.92-5.93) and 3.43 (95% CI: 2.79-4.22) postscarification. These data suggest PA-MNT may be a tool for quantifying ocular pain in calves. No differences (P < 0.1) in PA-MNT scores between scarified and not-scarified eyes were detected for any landmark on any day. This result suggests that the pain response occurs over the entire face, not just the affected eye. Corneal ulcerations consistent with IBK were not associated with statistically significant differences in PA-MNT or CTT at eye or calf levels. Not surprisingly, scarified eyes were more likely to exhibit blepharospasm and photophobia compared to healthy eyes. Due to blepharospasm, the use of the Cochet-Bonnet to evaluate corneal sensitivity by CTT was of limited value.

Short and long range order of the morphology of silk from Latrodectus hesperus (Black Widow) as characterized by atomic force microscopy

The surfaces of both stretched and unstretched silk threads from the cobweb weaver, Latrodectus hesperus (Black Widow) have been examined by atomic force microscopy (AFM). AFM images of cobweb scaffolding threads show both unordered and highly ordered regions. Two types of fibers within the threads were observed: thicker (approximately 300 nm in diameter) fibers oriented parallel to the thread axis and thinner (10-100 nm) fibrils oriented across the thread axis. While regions which lacked parallel fibers or fibrils were observed on threads at all strain values, the probability of observing fibers and/or fibrils increased with strain. High-resolution AFM images show that with increasing strain, both mean fiber and fibril diameters decrease and that fibrils align themselves more closely with the thread axis. The observation of fibers and fibrils within the cobweb threads has implications for current models of the secondary and tertiary structure and organization of spider silk.

The first randomized trial of human polymerized hemoglobin as a blood substitute in acute trauma and emergent surgery

BACKGROUND

Human polymerized hemoglobin (PolyHeme) is a universally compatible, disease-free, oxygen-carrying resuscitative fluid. This is the first prospective, randomized trial to compare directly the therapeutic benefit of PolyHeme with that of allogeneic red blood cells (RBCs) in the treatment of acute blood loss.

STUDY DESIGN

Forty-four trauma patients (33 male, 11 female) aged 19-75 years with an average Injury Severity Score (ISS) score of 21+/-10 were randomized to receive red cells (n = 23) or up to 6 U (300 g) of PolyHeme (n = 21) as their initial blood replacement after trauma and during emergent operations.

RESULTS

There were no serious or unexpected adverse events related to PolyHeme. The PolyHeme infusion of 4.4+/-2.0 units (mean +/- SD) resulted in a plasma [Hb] of 3.9+/-1.3 g/dL, which accounted for 40% of the total circulating [Hb]. There was no difference in total [Hb] between the groups before infusion (10.4+/-2.3 g/dL control vs. 9.4+/-1.9 g/dL experimental). At end-infusion the experimental RBC [Hb] fell to 5.8+/-2.8 g/dL vs. 10.6+/-1.8 g/dL (p < 0.05) in the control, although the total [Hb] was not different between the groups or from pre-infusion. The total number of allogeneic red cell transfusions for the control and experimental groups was 10.4+/-4.2 units vs. 6.8+/-3.9 units (p < 0.05) through day 1, and 11.3+/-4.1 units vs. 7.8 +/-4.2 units (p = 0.06) through day 3.

CONCLUSIONS

PolyHeme is safe in acute blood loss, maintains total [Hb] in lieu of red cells despite the marked fall in RBC [Hb], and reduces the use of allogeneic blood. PolyHeme appears to be a clinically useful blood substitute.

Practice parameter for the use of red blood cell transfusions: developed by the Red Blood Cell Administration Practice Guideline Development Task Force of the College of American Pathologists

A practice parameter has been developed to assist physicians in the therapeutic use of red blood cell transfusions. The developers of this parameter used the best available information from the medical literature, as well as clinical experience and the extensive reality testing required by the College of American Pathologists for approval. In acute anemia, a fall in hemoglobin values below 6 g/dL or a rapid blood volume loss of more than 30% to 40% requires red blood cell transfusions in most patients. However, tissue oxygenation provides a better indication of physiologic need in situations where invasive monitoring provides this information. When these data are not available, heart rate and blood pressure measurements and the nature of bleeding (active, controlled, uncontrolled) supplement the hemoglobin value in guiding the transfusion decision. In sickle cell disease and thalassemias, red blood cells are transfused to prevent acute or chronic complications. Red blood cell transfusions are used in chronic anemias unresponsive to pharmacologic agents based on the patient's symptoms. Guidelines must be altered for neonates who require an increase in hematocrit to above 0.30 to 0.35 when respiratory distress is present. Indications for red blood cell transfusion for the pregnant or postpartum patient are similar to those for the nonpregnant patient. Risks of transfusion, particularly transmissible disease and incompatibility, remain but have been reduced. Thus, red blood cell transfusion continues to be a powerful therapeutic tool when used judiciously and carries less risk than in the recent past.

Clinical utility of human polymerized hemoglobin as a blood substitute after acute trauma and urgent surgery

We have previously documented the safety of 1 unit (50 gram) of human polymerized hemoglobin (Poly SFH-P) in healthy volunteers. This report describes the first patient trial to assess the therapeutic benefit of Poly SFH-P in acute blood loss. Thirty-nine patients received 1 (n = 14), 2 (n = 2), 3 (n = 15), or 6 (n = 8) units of Poly SFH-P instead of red cells as part of their blood replacement after trauma and urgent surgery. There were no safety issues related to the infusion of Poly SFH-P. The plasma hemoglobin concentration ([Hb]) after the infusion of 6 units (300 gram) of Poly SFH-P was 4.8 +/- 0.8 g/dL (mean +/- SD). Although the red cell [Hb] fell to 2.9 +/- 1.2 g/dL, the total [Hb] was maintained at 7.5 +/- 1.2 g/dL. Poly SFH-P maintained total [Hb], despite the marked fall in red cell [Hb] due to blood loss. The utilization of O2 (extraction ratio) was 27 +/- 16% from the red cells and 37 +/- 13% from the Poly SFH-P. Twenty-three patients (59%) avoided allogeneic transfusions during the first 24 hours after blood loss. Poly SFH-P effectively loads and unloads O2 and maintains total hemoglobin in lieu of red cells after acute blood loss, thereby reducing allogeneic transfusions. Poly SFH-P seems to be a clinically useful blood substitute.

Clinical development of human polymerized hemoglobin as a blood substitute

Although the efficacy of hemoglobin-based oxygen carriers was established more than 60 years ago, all prior clinical trials have demonstrated significant toxicity characterized by renal dysfunction, gastrointestinal distress, and systemic vasoconstriction. The mechanisms of these toxicities now appear to be understood. Tetrameric forms of the hemoglobin molecule extravasate from the circulation and interact with endothelium-derived relaxing factor, leading to unopposed vasoconstriction. Although numerous efforts are under way to chemically modify the native tetramer, it is likely that all tetrameric forms of the hemoglobin molecule will continue to extravasate. We have focused on developing a polymerized form of hemoglobin that is virtually free of unreacted tetramer. The development and characterization of this polymerized pyridoxylated hemoglobin solution (Poly SFH-P) is described. Clinical trials have been completed successfully in volunteers and are now under way to assess the safety and efficacy of Poly SFH-P as a clinically useful red blood cell substitute for treatment of acute blood loss in the setting of trauma and surgery.

Acute dilutional anemia and critical left anterior descending coronary artery stenosis impairs end organ oxygen delivery

OBJECTIVE

Limited cardiac reserve, secondary to coronary disease, may be associated with end organ morbidity. In this study, we investigate the significance of anemia in the pathogenesis of this phenomenon.

DESIGN

Nonrandomized controlled animal trial.

SETTINGS

Animal laboratory in a university hospital.

SUBJECT

Anesthetized dogs. INTERVENTIONS/MEASUREMENTS: Fourteen anesthetized dogs underwent isovolemic hemodilution with 6% hetastarch from a baseline hematocrit of 40 to 20%. Radioactive microspheres were used to evaluate regional blood flow and cardiac index. Systemic oxygen delivery, consumption, serum lactate, and systemic vascular resistance were recorded during each experiment. Arterial venous oxygen difference was determined from arterial and mixed venous blood. Seven dogs had an iatrogenic critical stenosis of their left anterior descending coronary artery (experimental group); seven dogs did not (control).

MAIN RESULTS

Only in the control animals, the cardiac index increased by 35% with hemodilution to 20%. Systemic oxygen delivery decreased in both the control and the experimental animals. Systemic oxygen consumption and lactate levels were unchanged in both groups. In the renal cortex, spleen, distal colon, ileum, gallbladder, and stomach body, regional O2 delivery was significantly decreased with hemodilution to 20% in both groups. This finding was also observed in the left ventricle and cervical spinal cord in the experimental group. In addition, regional O2 delivery was reduced in the spleen, distal colon, and gallbladder with hemodilution to only 30%. Regional blood flow in the stomach body, gallbladder, ileum, renal cortex, and distal colon, in both groups, and the spleen in the control group was unchanged from baseline with hemodilution to 20%. However, regional blood flow under all other circumstances (control or experimental) was significantly increased with hemodilution to 20% with the exception of the spleen, which showed significant regional blood flow decrease in the experimental group only.

CONCLUSIONS

These data suggest that with limited cardiac reserve, anemia may compromise aerobic splanchnic circulation. These observations may further our understanding of the pathogenesis of cholecystitis, gastric stress ulcers, ileal endotoxin translocation, and ischemic colitis in critically ill patients with coronary artery disease.

The development of hemoglobin solutions as red cell substitutes: hemoglobin solutions

Although the efficacy of hemoglobin-based oxygen carriers was established more than 60 years ago, all prior clinical trials have demonstrated significant toxicity characterized by renal dysfunction, gastrointestinal distress, and systemic vasoconstriction. The mechanisms of these toxicities now appear to be understood. Tetrameric forms of the hemoglobin molecule extravasate from the circulation and interact with endothelial derived relaxing factor, leading to unopposed vasoconstriction. Although numerous efforts are underway to chemically modify the native tetramer, it is likely that all tetrameric forms of the hemoglobin molecule will continue to extravasate. We have focused on developing a polymerized form of hemoglobin that is virtually free of unreacted tetramer. The development and characterization of this polymerized pyridoxylated hemoglobin solution (Poly SFH-P) is described. Clinical trials have been completed successfully in volunteers, and are now underway to assess the safety and efficacy of Poly SFH-P as a clinically useful red cell substitute in the treatment of acute blood loss in the setting of trauma and surgery.

Guidelines for blood utilization review

Hospitals are required by accrediting agencies to perform blood utilization review. Specific areas that must be addressed are the ordering, distribution, handling, dispensing, and administration of blood components. Monitoring the effects of transfusion on patients is also required. The format of the review process and the criteria for appropriate blood utilization must be developed by each institution. This article provides examples of areas that can be reviewed and procedures that may be used. However, the suggested laboratory values must not be interpreted as defining indications or criteria for transfusion. Each transfusion committee, or its equivalent, is responsible for developing its own institutional blood utilization procedures and audit criteria. Review and approval by the medical staff prior to implementation are essential. The procedures must also be reviewed and revised on a regular basis.

Effects of recombinant human erythropoietin and interleukin-3 on erythropoietic recovery from acute anemia

The risks inherent in the use of homologous blood products have increased efforts toward identifying alternatives to transfusion. We have previously shown that the administration of recombinant human erythropoietin (rhEpo) enhances the erythropoietic response to acute blood loss. Recombinant human interleukin-3 (rh-IL-3) is a hematopoietic growth factor that has been shown to act synergistically with rhEpo in accelerating erythropoiesis in vitro. The purpose of this study in a primate model was to determine if the administration of rhIL-3 in combination with rhEpo could augment the erythropoietic response to acute blood loss more than rhEpo therapy alone. Twenty-four adult male baboons were randomized into four groups. The induction of acute normovolemic anemia to a hematocrit of 20% was accomplished via exchange-transfusion with 6% hetastarch. The groups were then treated for 7 consecutive days with the following growth factors: group I (n = 7), no growth factors; group II (n = 5), rhIL-3 alone (100 micrograms/kg/d); group III (n = 6), rhEpo alone (1000 U/kg/d); group IV (n = 6), rhEpo (1000 U/kg/d) plus rhIL-3 (100 micrograms/kg/d). All animals received folate, vitamin B12, and intravenous iron-dextran immediately following the exchange-transfusion. Response to therapy was monitored for 35 days. There were no adverse reactions following growth factor administration. The analysis of erythropoietic rates between study days 1 through 11, as determined via linear regression analysis, revealed that hematocrits increased significantly faster in the groups receiving rhEpo compared to controls. The administration of rhIL-3, however, did not increase the rate of erythropoiesis when compared to controls, nor did it augment response when added to the rhEpo regimen. The results of this study demonstrate that the administration of rhIL-3 alone had no significant effect on erythropoiesis in this setting of acute blood loss. Further, despite promising in vitro data, rhIL-3 provided no additional stimulation of erythropoiesis in animals receiving rhEpo. Nevertheless, the study confirms that the pharmacologic acceleration of erythropoiesis by rhEpo alone remains an attractive alternative to homologous transfusion.

Limit to cardiac compensation during acute isovolemic hemodilution: influence of coronary stenosis

We assessed limit to cardiac compensation during isovolemic hemodilution (HD) in 14 anesthetized dogs. Radioactive microspheres were used to evaluate myocardial blood flow (MBF) and its transmural distribution (endo/epi). Myocardial O2 consumption (MVO2) and percent lactate extraction were determined. Coronary vasodilator reserve was assessed from reactive hyperemic responses. Dogs were divided into group 1, with intact left anterior descending coronary artery (LAD), and group 2, with critical stenosis of LAD. Measurements were obtained at baseline and during graded HD (Hespan) until cardiac failure (CF). CF occurred at lower hematocrit in group 1 compared with group 2 (9 +/- 1 vs. 17 +/- 1%). In group 1, MBF increased during HD to maintain MVO2 constant; increases in MBF were transmurally uniform until CF, when decreased endo/epi and lactate production suggested subendocardial ischemia. Coronary vasodilator reserve decreased progressively during HD and was absent at CF. In group 2, stenotic LAD demonstrated constant MBF (resulting in decreased MVO2) during HD. At CF, these responses along with reduced endo/epi and lactate production indicated local myocardial ischemia. We conclude that 1) with normal coronary circulation, cardiac function was well maintained over a wide range of hematocrits because increases in MBF were transmurally uniform and sufficient to maintain myocardial oxygenation: CF occurred during extreme HD when MBF became maldistributed, resulting in subendocardial ischemia; 2) critical coronary stenosis impaired coronary vascular adjustment to HD and reduced significantly tolerance of left ventricle to HD; and 3) present findings underscore the importance of recruitment of coronary vasodilator reserve in preserving total and regional myocardial oxygenation during HD.

Hypovolemic shock

This article defines a rational approach to the treatment of hemorrhagic shock. All patients that are hypovolemic following hemorrhage require fluid resuscitation. Some patients require red cell restoration and very few require correction of any clotting deficiencies. A physiologic approach to these problems will lead to optimal patient care in these circumstances.

Oxygen extraction ratio: a valid indicator of transfusion need in limited coronary vascular reserve?

We have described whole body oxygen (O2) extraction ratio (ER) as a reliable indicator of transfusion need in acute normovolemic anemia. In normal hearts, myocardial lactate production (-LACT), indicating anaerobic metabolism, does not occur until the ER greater than 50% and Hct less than 10%. It is not known if the ER is valid in the setting of limited coronary vascular reserve. This study assesses the effect of a critical left anterior descending (LAD) coronary stenosis on the compensation to acute blood loss anemia. Adult dogs were anesthetized, paralyzed, and mechanically ventilated. A critical LAD stenosis was created in seven animals (STEN). There were seven controls (CON). Animals underwent isovolemic exchange transfusion with 6% HES until cardiac failure (CF). Catheters were placed in the aorta, pulmonary artery, and anterior interventricular coronary vein. Cardiac failure occurred at Hct = 8.6% +/- 0.4% in the CON and 17.0% +/- 0.5% in the STEN animals. Cardiac output increased in the CON, but not in the STEN animals. Blood flow in the LAD increased in the CON but not the STEN animals. -LACT began in the CON and STEN animals at Hct less than 20% and coincided with an ER greater than 50% in both groups. We conclude that CF occurs at a higher hematocrit with a critical LAD stenosis. The whole body ER greater than 50% remains a valid indicator of myocardial metabolism in anemia in the presence of limited coronary vascular reserve. The ER may be a useful guide to transfusion therapy.

Artificial blood: current status of hemoglobin solutions

Attempts to develop a hemoglobin-based red cell substitute have spanned many decades, but no clinically useful product has been produced to date. The issues preventing clinical application primarily are ones of safety--not efficacy. Numerous animal studies have documented the efficacy of SFH. Although effective, the solution has limitations that have caused concern. Oncotic considerations limit the concentration of the infusate SFH to 6 to 8 g/dL, or half-normal. Owing to the loss of organic phosphate modulators of P50, such as 2,3-DPG, the P50 of SFH is typically between 12 and 14 mm Hg, which is also half the normal value. And finally, the intravascular half-life of SFH is too short, ranging only from 2 to 6 hr. Polymerization provides a means of correcting these limitations. The high oxygen affinity can be greatly diminished by covalent binding of pyridoxal-5'-phosphate to the N-terminal of the chains. Colloid osmotic pressure exerted by a protein solution is proportional to the number of discrete colloid particles. Through polymerization, the number of colloid particles is reduced, leading to a decrease in COP. Data show that this can be achieved in a reproducible fashion. The rate at which COP diminishes determines the yield of polymeric species, as well as their molecular weight distribution. Polymerization can be controlled to result in a yield of 75% to 85% polymers with a molecular weight distribution of 128 to 400 kd. The number average and the weight average molecular weights indicate that the large proportion of polymers represent the cross linking of two tetramers. The data that reflect the interaction of oxygen with poly-SFH-P indicate that the oxygen carrying function of hemoglobin has not been significantly altered by the chemical modifications. The binding coefficient of oxygen is unchanged. As anticipated, there is a loss of cooperativity (diminished Hill coefficient) between the hemoglobin chains, suggesting structural restrictions in the polymeric species because of cross linking. A reduced alkaline Bohr effect is the expected result, and data confirm this. Finally, some increase in oxygen affinity is to be expected with polymerization. This is indeed the case, although the P50 of poly-SFH-P is comparable to banked blood (18 to 22 mm Hg). To be clinically useful, a modified hemoglobin solution requires a reasonable shelf-life.(ABSTRACT TRUNCATED AT 400 WORDS)

Erythropoietin deficiency after coronary artery bypass procedures

Erythropoietin is the primary regulator of erythropoiesis. Erythropoietin has been shown to increase exponentially in response to linear decreases in hematocrit in normal, unstressed animals. However, the effect of operation, with its attendant stress, on erythropoietin levels is unknown. The purpose of this study is to evaluate the effect of surgical stress on erythropoietin. Twenty otherwise healthy patients scheduled for elective surgical procedures were studied. The cholecystectomy group included 10 patients who underwent cholecystectomy for documented stone disease. Ten patients who underwent coronary artery bypass procedures constituted the coronary artery bypass grafting group. Patients were studied preoperatively as well as on the first and second postoperative days. The hematocrit and erythropoietin levels were similar in both groups preoperatively. The hematocrit in the coronary artery bypass grafting group was lower than that of the cholecystectomy group on postoperative day 1 (0.31 versus 0.36; p less than 0.003) and postoperative day 2 (0.30 versus 0.36; p less than 0.001). During the first two postoperative days the erythropoietin levels were similar between groups. The data show that postoperative erythropoietin levels are similar after coronary artery bypass grafting, despite more severe anemia, when compared with cholecystectomy. This suggests that after coronary artery bypass grafting there is a relative deficiency of erythropoietin. Administration of recombinant human erythropoietin to patients undergoing surgical procedures could correct the erythropoietin deficiency and accelerate postoperative erythropoiesis.

Atomic force microscopy of hydrated phosphatidylethanolamine bilayers

We present images of the polar or headgroup regions of bilayers of dimyristoyl-phosphatidylethanolamine (DMPE), deposited by Langmuir-Blodgett deposition onto mica substrates at high surface pressures and imaged under water at room temperature with the optical lever atomic force microscope. The lattice structure of DMPE is visualized with sufficient resolution that the location of individual headgroups can be determined. The forces are sufficiently small that the same area can be repeatedly imaged with a minimum of damage. The DMPE molecules in the bilayer appear to have relatively good long-range orientational order, but rather short-range and poor positional order. These results are in good agreement with x-ray measurements of unsupported lipid monolayers on the water surface, and with electron diffraction of adsorbed monolayers.

Immobilized proteins in buffer imaged at molecular resolution by atomic force microscopy

Samples of supported planar lipid-protein membranes and actin filaments on mica were imaged by atomic force microscopy (AFM). The samples were fully submerged in buffer at room temperature during imaging. Individual proteins bound to the reconstituted membrane were distinguishable; some structural details could be resolved. Also, surface-induced, self-assembling of actin filaments on mica could be observed. Monomeric subunits were imaged on individual actin filaments. The filaments could be manipulated on or removed from the surface by the tip of the AFM. The process of the decoupling of the filamentous network from the surface upon changing the ionic conditions was imaged in real time.

Imaging cells with the atomic force microscope

Different types of cells have been imaged with the atomic force microscope. The morphology of the archaebacterium Halobacterium halobium in its dry state was revealed. On a leaf of the small Indian tree Lagerstroemia subcostata a stoma was imaged. The lower side of a water lily leaf was imaged in water showing features down to 12 nm. Finally, fixed red and white blood cells were imaged in buffer showing features down to 8 nm. The images demonstrate that atomic force microscopy can provide high-resolution images of cell surfaces under physiological conditions.

The efficacy of polymerized pyridoxylated hemoglobin solution as an O2 carrier

A polymerized pyridoxylated hemoglobin solution (Poly SFH-P) has been prepared with a normal [Hb] of 14 g/dL, a normal COP of 20 to 25 torr, a P50 of 16 to 20 torr, and a plasma T1/2 of 40 to 46 hours. Animals underwent a total exchange transfusion with Poly SFH-P to assess its ability to support hemodynamics and oxygen transport in the absence of red cells. All animals survived the exchange transfusion. Mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), and oxygen consumption (VO2) remained at baseline values at zero hematocrit after the exchange. The final plasma [Hb] at Hct less than 1% was 9.7 +/- 0.4 g/dL. These results are significantly better than previous data with unmodified tetrameric hemoglobin solution (SFH). Poly SFH-P supports life in the absence of red cells. In contrast to SFH, Poly SFH-P achieves a nearly normal [Hb], a longer T1/2, and maintains baseline hemodynamics and oxygen consumption at zero hematocrit. These results document that Poly SFH-P is an effective oxygen carrier that offers greater potential than previous products as a clinically useful red cell substitute.

Imaging and Manipulating Molecules on a Zeolite Surface with an Atomic Force Microscope

The adsorption of neutral molecules and ions on the surfaces of zeolites was observed in real time with an atomic force microscope (AFM). Direct imaging of the surface of the zeolite clinoptilolite was possible by using a diluted tert-butyl ammonium chloride solution as a medium. Images of the crystal in different liquids revealed that molecules could be bound to the surface in different ways; neutral molecules of tert-butanol formed an ordered array, whereas tert-butyl ammonium ions formed clusters. These absorbed molecules were not rearranged by the AFM tip when used in an imaging mode. However, when a sufficiently large force was applied, the tip of the AFM could rearrange the tert-butyl ammonium ions on the zeolite surface. This demonstration of molecular manipulation suggests new applications, including biosensors and lithography.

Erythropoietic response to acute anemia

Reliance on a brisk erythropoietic response to untreated blood loss is an alternative to transfusion of homologous blood. Slow erythropoiesis has been observed in ICU patients who refused blood. Many of these patients received supplemental oxygen therapy and Fluosol-DA, a temporary red cell substitute. This study reports the erythropoietic response, in the baboon, to moderate (Hct 20%) and severe (Hct 10%) anemia. In addition, the effect of oxygen therapy (FIO2 0.6 for 1 wk) and fluorocarbon emulsions (Oxypherol) on erythropoiesis was evaluated. Baboons uniformly survived acute normovolemic anemia with Hct 10%. In all cases, the response to anemia was characterized by a lag period (with no change in Hct), and a nonlinear recovery period. A lag period of 3 days was observed in both moderate and severe anemia for baboons breathing room air or FIO2 0.6. The lag period was prolonged to 1 wk in the presence of Oxypherol. The recovery period exhibited a uniform and negative correlation between the rate of Hct change and the Hct, in all cases. The theoretical maximum rate of increase of Hct was 2.6%/day. In untreated blood loss, shortening the lag period and increasing the slope of the recovery period will decrease the length of time that the patient is anemic.

Effect of hemoglobin solution on compensation to anemia in the erythrocyte-free primate

Hemoglobin solutions are undergoing clinical trials as erythrocyte substitutes. Some of these solutions have higher O2 affinities compared with normal erythrocyte hemoglobin. Also, they appear to interact with endothelial-derived smooth muscle relaxation. The purpose of this study was to evaluate the nature and limits of compensation to acute normovolemic anemia in the erythrocyte-free primate maintained with a hemoglobin solution. The experimental group consisted of six anesthetized paralyzed adult baboons (Papio anubis) that were exchange transfused (ET) with a pyridoxylated polymerized hemoglobin solution [hemoglobin concentration [( Hb]) = 14 g/dl, O2 half-saturation pressure of hemoglobin (P50) = 19.6 Torr] until a hematocrit less than 1% was achieved. They underwent a second ET with Dextran-70 until [Hb] = 1 g/dl. A control group (n = 6) underwent an ET with Dextran-70 until [Hb] = 1 g/dl. Both groups maintained O2 consumption (VO2) until [Hb] = 3 g/dl. Both groups were stable until [Hb] less than 1 g/dl, and both groups increased their cardiac output. The relation between VO2 and O2 delivery was similar for both groups. In vivo P50 and mixed venous O2 tension were significantly lower in the experimental group. The nature and limits of compensation to diminished O2 delivery due to anemia were similar in the two groups.

STM and AFM images of nucleosome DNA under water

We have imaged DNA from the calf thymus nucleosome using a scanning tunneling microscope (STM) operated in water. The fragments are deposited onto the interface between a buffer solution and an epitaxially grown gold surface using an electrochemical tecnique. Most of the fragments are fairly straight, and when individual polymers can be identified, their length is consistent with the expected 146 basepairs (approximately 500 A). The resolution is often adequate to show signs of the 36 A helical pitch. Some images show a structure which appears to have abrupt kinks of the sort predicted by Crick and Klug (Nature 255, 530-533, 1975). In order to check that this shape is not a consequence of binding to underlying structure on the gold substrate, we have also made images of kinked structures using an atomic force microscope (AFM) with the DNA bound to glass.

Treatment of acute postoperative anemia with recombinant human erythropoietin

Risks inherent in the administration of blood products have increased efforts to avoid homologous transfusion. Although this has increased interest in autologous transfusion and intraoperative salvage, little attention has been focused on efforts to enhance endogenous erythropoiesis as a method of minimizing exposure to homologous blood. Recombinant human erythropoietin (rHuEPO) has been shown to enhance erythropoiesis. The purpose of this study is to evaluate the effect of rHuEPO, administered postoperatively, on a model of acute blood loss. Eleven adult male baboons were randomized into two groups. All animals underwent a laparotomy and an exchange transfusion, with 6% hetastarch, to a final hematocrit of 15%. Group I (N = 6) received 1,000 units/kg of recombinant human erythropoietin daily for the first 14 postoperative days. Group II (N = 5) received an equivalent volume of placebo. All animals were given supplemental vitamin B12, folate and 200% of shed iron, as iron dextran IV, after exchange transfusion. Response was observed for a period of 35 days. All animals survived the protocol. There were no adverse reactions to rHuEPO or surgical complications. The hematocrits were similar between groups at baseline and after exchange transfusion. The maximal rate of erythropoiesis was significantly faster in the rHuEPO group (2.1 vs. 1.3%/day; p less than 0.01). The time required to return to hematocrits of 30% (9.9 vs. 17.4 days, p less than 0.001) and to baseline hematocrits (11.9 vs. 32.1 days, p less than 0.01) were both significantly shorter in the rHuEPO group. The data show that rHuEPO accelerates the recovery from anemia in the postoperative setting. Acceleration of erythropoiesis represents another alternative to homologous transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Perioperative recombinant human erythropoietin

The risks of transfusion-associated infectious disease have made increased efforts to avoid homologous transfusion imperative. Little attention has been focused on efforts to accelerate erythropoiesis as a method of reducing homologous blood use. Recombinant human erythropoietin (rHuEPO) has been shown to enhance erythropoiesis. The purpose of this study was to evaluate the effects of perioperative rHuEPO administration on postoperative erythropoiesis. Fifteen baboons were divided into three groups of five each. Group I received no rHuEPO. Group II received five daily preoperative doses of rHuEPO (1000 U/kg). Group III received five daily preoperative doses and 14 daily postoperative doses of rHuEPO (1000 U/kg). All animals underwent a laparotomy followed by an exchange transfusion to a final hematocrit of 15%. The time in days required to recover to hematocrits of 20% was significantly shorter in both groups that received preoperative doses of rHuEPO when compared with that of controls (3.3 vs 5.7 days, p less than 0.01). The recovery times to hematocrits of 25%, 30%, and baseline levels were all significantly shorter in the group that received both preoperative and postoperative doses of rHuEPO. The data show that perioperative dosage of rHuEPO significantly accelerates postoperative erythropoiesis. Perioperative administration of rHuEPO may reduce the requirements for homologous transfusion.