Characterization of Chronic Enteropathies in Dogs by Use of Fecal and Urinary N-methylhistamine Concentrations and Serum Methylmalonic Acid Concentrations

Non-invasive markers that are clinically useful for the diagnosis and monitoring of canine chronic enteropathies are scarce. The first aim of this study was to investigate the prevalence of cobalamin deficiency on a cellular level in dogs with chronic gastrointestinal disease by measuring serum methylmalonic acid (MMA) concentrations. Hypocobalaminemia has been associated with a negative outcome in dogs with chronic enteropathies, but the prevalence of cellular cobalamin deficiency is unknown. The second aim of this study was to determine the utility of fecal and urinary concentrations of N-methylhistamine (NMH) as a marker of gastrointestinal inflammation and disease activity in dogs with chronic enteropathies. Serum MMA concentrations were measured in healthy control dogs to establish a reference interval, which was calculated to be 415-1,193 nmol/L. Measurement of MMA concentrations in 555 serum samples from dogs with varying cobalamin concentrations showed a significant increase (p<0.05) in dogs with hypocobalaminemia. In a prospective group of 56 dogs with chronic enteropathies, 36% had decreased serum cobalamin concentrations, five of which (9% of 56 dogs) had increased serum MMA concentrations. We conclude that hypocobalaminemia is commonly seen in dogs with chronic gastrointestinal disease, but does not always appear to be associated with cellular cobalamin deficiency. In 47 dogs with chronic enteropathies, fecal and urinary NMH concentrations were increased in 21% and 27%, respectively, indicating that mast cell degranulation plays a role in a subset of dogs with chronic enteropathies. However fecal and urinary NMH concentrations did not correlate with each other, or with the clinical activity index. Urinary NMH concentrations correlated significantly with serum CRP concentrations, and were also significantly associated with severity of duodenal mucosal inflammation (p=0.008). The lack of correlation with the clinical activity index suggests that degranulation of mast cells only plays a role in some dogs with chronic enteropathies. Also, these results suggest that NMH alone may not be a good marker for clinical disease activity in dogs with chronic enteropathies. Due to its linear association with serum CRP and severity of mucosal inflammation, urinary NMH concentrations may be a better marker of intestinal inflammation than fecal NMH concentrations

Correlating Gastrointestinal Histopathologic Changes to Clinical Disease Activity in Dogs With Idiopathic Inflammatory Bowel Disease

Prior studies have failed to detect a convincing association between histologic lesions of inflammation and clinical activity in dogs with inflammatory bowel disease (IBD). We hypothesized that use of a simplified histopathologic scoring system would improve the consistency of interpretation among pathologists when describing histologic lesions of gastrointestinal inflammation. Our aim was to evaluate the correlation of histopathologic changes to clinical activity in dogs with IBD using this new system. Forty-two dogs with IBD and 19 healthy control dogs were enrolled in this retrospective study. Endoscopic biopsies from the stomach, duodenum, ileum, and colon were independently scored by 8 pathologists. Clinical disease activity was scored using the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) or the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), depending on the individual study center. Summative histopathological scores and clinical activity were calculated for each tissue (stomach, duodenum, ileum, and colon) and each tissue histologic score (inflammatory/morphologic feature). The correlation between CCECAI/CIBDAI and summative histopathologic score was significant (P < .05) for duodenum (r = 0.42) and colon (r = 0.33). In evaluating the relationship between histopathologic scores and clinical activity, significant (P < .05) correlations were observed for crypt dilation (r = 0.42), lamina propria (LP) lymphocytes (r = 0.40), LP neutrophils (r = 0.45), mucosal fibrosis (r = 0.47), lacteal dilation (r = 0.39), and villus stunting (r = 0.43). Compared to earlier grading schemes, the simplified scoring system shows improved utility in correlating histopathologic features (both summative histology scores and select histologic scores) to IBD clinical activity

Anti-PD-1/anti-CTLA-4 efficacy in melanoma brain metastases depends on extracranial disease and augmentation of CD8+ T cell trafficking

Inhibition of immune checkpoints programmed death 1 (PD-1) and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) on T cells results in durable antitumor activity in melanoma patients. Despite high frequency of melanoma brain metastases (BrM) and associated poor prognosis, the activity and mechanisms of immune checkpoint inhibitors (ICI) in metastatic tumors that develop within the “immune specialized” brain microenvironment, remain elusive. We established a melanoma tumor transplantation model with intracranial plus extracranial (subcutaneous) tumor, mimicking the clinically observed coexistence of metastases inside and outside the brain. Strikingly, intracranial ICI efficacy was observed only when extracranial tumor was present. Extracranial tumor was also required for ICI-induced increase in CD8+ T cells, macrophages, and microglia in brain tumors, and for up-regulation of immune-regulatory genes. Combined PD-1/CTLA-4 blockade had a superior intracranial efficacy over the two monotherapies. Cell depletion studies revealed that NK cells and CD8+ T cells were required for intracranial anti–PD-1/anti–CTLA-4 efficacy. Rather than enhancing CD8+ T cell activation and expansion within intracranial tumors, PD-1/CTLA-4 blockade dramatically (∼14-fold) increased the trafficking of CD8+ T cells to the brain. This was mainly through the peripheral expansion of homing-competent effector CD8+ T cells and potentially further enhanced through up-regulation of T cell entry receptors intercellular adhesion molecule 1 and vascular adhesion molecule 1 on tumor vasculature. Our study indicates that extracranial activation/release of CD8+ T cells from PD-1/CTLA-4 inhibition and potentiation of their recruitment to the brain are paramount to the intracranial anti–PD-1/anti–CTLA-4 activity, suggesting augmentation of these processes as an immune therapy-enhancing strategy in metastatic brain cancer

Understanding management gurus and historical narratives: The benefits of a historic turn in management and organization studies

A historic turn in organization studies requires a basic theoretical understanding of ‘doing history’ and an appreciation of the centrality of narrative in history. Following the cultural turn in history, narrativist historians and philosophers of history such as Hayden White, Frank Ankersmit and Paul Ricoeur have made the case that narrative is an essential and unavoidable component in history. We demonstrate the persuasive capacity of narrative through a narrativist critique of three best-selling ‘management gurus’. This analysis illustrates the following: (1) the narrative features of popular organizational theories; (2) the basis of the success of guru literature; and (3) why gurus and organizational scientists themselves do not understand the narratological mechanisms behind their success. Finally, we maintain that historical narrativism offers the possibility for positioning organizational history as a highly relevant field for management academics, gurus and even managers, providing support for a historic turn

Analytic validation of a gas chromatography-mass spectrometry method for quantification of six amino acids in canine serum samples.

OBJECTIVE To analytically validate a gas concentration of chromatography-mass spectrometry (GC-MS) method for measurement of 6 amino acids in canine serum samples and to assess the stability of each amino acid after sample storage. SAMPLES Surplus serum from 80 canine samples submitted to the Gastrointestinal Laboratory at Texas A&M University and serum samples from 12 healthy dogs. PROCEDURES GC-MS was validated to determine precision, reproducibility, limit of detection, and percentage recovery of known added concentrations of 6 amino acids in surplus serum samples. Amino acid concentrations in serum samples from healthy dogs were measured before (baseline) and after storage in various conditions. RESULTS Intra- and interassay coefficients of variation (10 replicates involving 12 pooled serum samples) were 13.4% and 16.6% for glycine, 9.3% and 12.4% for glutamic acid, 5.1% and 6.3% for methionine, 14.0% and 15.1% for tryptophan, 6.2% and 11.0% for tyrosine, and 7.4% and 12.4% for lysine, respectively. Observed-to-expected concentration ratios in dilutional parallelism tests (6 replicates involving 6 pooled serum samples) were 79.5% to 111.5% for glycine, 80.9% to 123.0% for glutamic acid, 77.8% to 111.0% for methionine, 85.2% to 98.0% for tryptophan, 79.4% to 115.0% for tyrosine, and 79.4% to 110.0% for lysine. No amino acid concentration changed significantly from baseline after serum sample storage at -80°C for ≤ 7 days. CONCLUSIONS AND CLINICAL RELEVANCE GC-MS measurement of concentration of 6 amino acids in canine serum samples yielded precise, accurate, and reproducible results. Sample storage at -80°C for 1 week had no effect on GC-MS results

Effect of gastric acid-suppressive therapy and biological variation of serum gastrin concentrations in dogs with chronic enteropathies

Abstract Background Serum gastrin concentration can help diagnose gastrinomas in dogs if >3–10× the upper reference limit (URL), but antisecretory therapy and other conditions can also cause hypergastrinemia. Effects of antisecretory therapy (famotidine or ranitidine, omeprazole) on serum gastrin concentration in dogs with chronic enteropathy (CE) and its biological variation (BV) are unknown. Aim of the study was to evaluate serum gastrin in acid-suppressant-treated or -naïve CE dogs; test the association between serum gastrin and histopathologic findings in acid-suppressant-naïve CE dogs; and evaluate the BV of serum gastrin in dogs not receiving any gastric acid suppressive therapy. Samples from 231 dogs were used and serum gastrin was measured by chemiluminescence assay. Gastric and duodenal histologic lesions were evaluated and graded. BV of serum gastrin was evaluated in serial samples. Results Serum gastrin concentrations were significantly higher in acid-suppressant-treated than acid-suppressant-naïve dogs (P = 0.0245), with significantly higher concentrations in proton pump inhibitor (PPI)- than H2-antihistamine-treated patients (P = 0.0053). More PPI- than H2-antihistamine-treated dogs had gastrin concentrations above URL (P = 0.0205), but not >3× nor >10× the URL. Serum gastrin concentrations correlated with the severity of gastric antral epithelial injury (P = 0.0069) but not with any other lesions or the presence/numbers of spiral bacteria in gastric biopsies. Intra- and inter-individual BV were 43.4 and 21.6%, respectively, in acid-suppressant-naïve dogs, with a reciprocal individuality index of 0.49 and a critical difference of ≥29.5 ng/L. Conclusions Antisecretory (particularly PPI) treatment leads to hypergastrinemia in CE dogs, but the concentrations seen in this study are unlikely to compromise a diagnosis of gastrinoma. Use of a population-based URL for canine serum gastrin and a URL of ≤27.8 ng/L are appropriate

Development and analytical validation of a radioimmunoassay for the measurement of alpha₁-proteinase inhibitor concentrations in feces from puppies and healthy adult dogs

Canine α1-proteinase inhibitor (cα₁-PI), a proteolysis-resistant protein with a molecular weight similar to albumin, has been shown to be clinically useful as a marker for gastrointestinal protein loss in dogs. A competitive, liquid-phase radioimmunoassay was developed and analytically validated. Fecal samples were collected from 101 healthy pet dogs of various breeds and ages, and fecal cα₁-PI (Fcα₁-PI) concentrations were compared between dogs of different age groups. A reference interval for Fcα₁-PI concentration was calculated using the central 95th percentile. Analytical sensitivity of the assay was 2.2 μg Fcα₁-PI/g feces. Observed-to-expected ratios for the serial dilution and spiking recovery of 9 and 6 fecal extracts ranged from 90.4 to 152.0% and from 71.3 to 112.3%, respectively. Coefficients of variation for intra- and interassay variability for 6 fecal extracts were ≤10.8% and ≤12.5%, respectively. The reference intervals for the mean and maximum Fcα₁-PI from fecal samples collected on 3 consecutive days were 2.2 13.9 μg/g and 2.2-21.0 μg/g, respectively. Fcα₁-PI was significantly higher in dogs 13.9 μg/g or &gt;21.0 μg/g, respectively, should be considered abnormal in dogs &gt;1 year of age. Fecal cα₁ PI concentrations in dogs 21.0 μg/g, respectively, should be considered abnormal in dogs &gt;1 year of age. Fecal cα₁ PI concentrations in dogs 1 year of age. Fecal cα₁ PI concentrations in dog

Development and analytic validation of an electron ionization gas chromatography/mass spectrometry (EI-GC/MS) method for the measurement of 3-bromotyrosine in canine serum

BACKGROUND The activation of eosinophils causes the release of eosinophil peroxidase and subsequent production of 3-bromotyrosine (3-BrY), a stable byproduct. In people, 3-BrY is used as a biomarker for eosinophil activation. The method for measuring 3-BrY concentrations in biologic samples from dogs has not previously been described. OBJECTIVES The objective of this study was to develop and analytically validate an electron ionization gas chromatography/mass spectrometry (EI-GC/MS) method for the measurement of 3-BrY in canine serum samples. METHODS Pooled canine serum samples were utilized to validate the assay. Serum samples from healthy control dogs (n = 41) were used to evaluate 3-BrY concentrations and establish a reference interval. RESULTS The analytic validation revealed that the limit of blank and limit of detection were 0.33 and 0.63 μmol/L, respectively. The coefficients of variation for precision and reproducibility for 3-BrY were < 13.9% and < 11.0%, respectively. The means ± SD of observed-to-expected ratios for linearity and accuracy were 109.6 ± 17.2% and 98.7 ± 11.3%, respectively. The reference interval was determined as ≤ 1.12 μmol/L (median [range]: ≤ 0.63 μmol/L [≤ 0.63-1.13]). CONCLUSIONS The EI-GC/MS assay described here for the measurement of 3-BrY in canine serum samples was precise, reproducible, linear, and accurate. Further studies are underway to determine the diagnostic utilities in canine patients with eosinophilic diseases