Idiopathic esophagopathies resembling gastroesophageal reflux disease in dogs

OBJECTIVE: Pathologic gastroesophageal reflux (GER) has been demonstrated experimentally in dogs, and it is suspected to occur naturally in dogs, yet its clinical significance is unknown. The aim of the study was to demonstrate clinical indicators of pathologic GER in dogs with idiopathic esophagopathies. MATERIALS AND METHODS: Dogs with clinical signs suggestive for esophageal disease (regurgitation, ptyalism, or dysphagia) and where extraesophageal and specific esophageal diseases had been ruled out, were retrospectively diagnosed with idiopathic esophagopathies. History, physical examination findings, clinicopathologic, radiographic, and endoscopic data, and treatment results were obtained from medical records, reviewed and evaluated. RESULTS: Out of 67 dogs with anamnestic esophageal signs, 12 (17.4%) dogs were identified as having idiopathic esophagopathies and were included in the study. Median age was 3.0 years (range 1.0-11.0), and median bodyweight was 28.2 kg (range 8.2-44.0). The most frequent anamnestic esophageal signs were ptyalism (10/12 dogs), regurgitation (8/12 dogs), signs of discomfort, pain (8/12 dogs), and cough (5/12 dogs). The most common radiographic abnormality was segmental esophageal dilation (8/12 dogs). Esophagoscopy revealed single mucosal surface defects at the gastroesophageal junction in 3/12 dogs. In dogs with altered esophageal motility, cytological and microbiological examinations of bronchial aspirates showed goblet cell hyperplasia (8/8 dogs), neutrophilic infiltration (5/8 dogs) and culturable bacteria (4/8 dogs), respectively. All dogs were treated with omeprazole (median 0.7 mg/kg once per day, range 0.5-1.2). Reported median treatment duration until remission of the main clinical signs was 20.0 days (range 8.0-54.0 days). This endpoint was reached in 11/12 dogs. CONCLUSION AND CLINICAL RELEVANCE: Results suggest that in some dogs with esophageal clinical signs, and where no primary disease could be identified, clinical indicators of pathologic GER such as pain, mucosal lesions and motility disturbances of the esophagus, respiratory complications, and response to therapy can be observed

Bestimmung der hyperregeneratorischen Ösophago - pathie bei Hunden mit klinischen Anzeichen einer Speiseröhrenerkrankung

OBJECTIVE It was hypothesized that typical characteristics of hyperregeneratory esophagopathy (HRE) in humans such as basal cell hyperplasia and elongation of stromal papillae are also histologically detectable in canine esophageal epithelium, and that these changes are associated with clinical signs and endoscopic findings suggesting gastroesophageal reflux (GER). MATERIAL AND METHODS Sixty-five adult dogs with clinical signs attributable to esophageal disease underwent esophagoscopy and biopsy. Clinical signs suggesting GER (regurgitation, ptyalism, painful discomfort) were prospectively evaluated through a questionnaire. Endoscopic mucosal alterations suggesting GER such as minimal endoscopic changes and obvious mucosal defects were assessed via video endoscopy. Biopsy specimens obtained from the esophageal squamous epithelium were evaluated histologically. The squamous epithelium's substructures of esophageal biopsies were quantitatively assessed through microscopic morphometry. RESULTS Esophageal squamous epithelium was considered normal in 48 dogs, and HRE was detected histologically in 17 dogs; both pathognomonic changes (basal cell hyperplasia, elongation of stromal papillae) were consistently present. Morphometrically assessed stromal papillary length and basal cell layer thickness was significantly (each, p < 0.0001) higher in the 17 dogs with HRE than in the 48 dogs without HRE, respectively. Overall, clinical signs suggesting GER were significantly (p = 0.02) more frequently encountered and regurgitation was significantly (p = 0.009) more common in the 17 dogs with HRE than in the 48 dogs without HRE. Similarly, endoscopic changes were significantly (p = 0.002) more frequently observed and minimal endoscopic changes suggesting GER were significantly (p = 0.004) more common in 17 dogs with HRE than in the 48 dogs without HRE. CONCLUSION AND CLINICAL RELEVANCE Typical characteristics of hyperregeneratory esophagopathy in humans are also histologically detectable in canine esophageal epithelium. Histological changes are associated with clinical signs and endoscopic findings suggesting GER

Identification of novel blood-based extracellular vesicles biomarker candidates with potential specificity for traumatic brain injury in polytrauma patients

ObjectiveThe goal of this study was to identify changes in extracellular vesicles (EV) surface proteins specific to traumatic brain injury (TBI), which could be used as a diagnostic and prognostic tool in polytrauma patients.Summary Background DataKnown serum TBI-specific biomarkers (S100B, NSE, and GFAP), which can predict the severity and outcome of isolated TBI, lose their predictive value in the presence of additional extracranial injuries. Extracellular vesicles (EVs) are released from cells in response to various stimuli and carry specific cargo/surface molecules that could be used for tracking injury-responding cells.MethodsEVs were isolated using size exclusion chromatography (SEC) from the plasma of two groups of patients (with isolated TBI, ISS≥16, AIShead≥4, n=10; and polytraumatized patients without TBI ISS≥16, AIShead=0, n=10) collected in the emergency room and 48 h after trauma. EVs’ surface epitope expression was investigated using a neurospecific multiplex flow cytometry assay and compared with healthy controls (n=10). Three enrichments of EV epitopes found to be specific to TBI were validated by western blot.ResultsThe expression of 10 EV epitopes differed significantly among the patient and control groups, and five of these epitopes (CD13, CD196, MOG, CD133, and MBP) were TBI-specific. The increased expression of CD196, CD13, and MOG-positive EVs was validated by western blot.ConclusionOur data showed that TBI is characterized by a significant increase of CD13, CD196, MOG, CD133, and MBP-positive EVs in patients’ plasma. A high level of MOG-positive EVs negatively correlated with the Glasgow Coma Scale score at admission and could be an indicator of poor neurological status