Symmetrisk Lupoid Onychodystrofi hos hund : en journalstudie samt analys av antinukleära antikroppar, ANA

Symmetrisk Lupoid onychodystrofi, SLO, beskrevs för första gången på mitten av 90-talet. Sjukdomen karaktäriseras av att alla klor avlossas inom en kort tidsperiod utan att andra samtidiga systemiska fynd ses. Den bakomliggande orsaken till sjukdomen är ännu inte känd, men eftersom liknande histologiska fynd som vid systemisk lupus erythematosus, SLE och kutan lupus erythematosus, LE, kan identifieras har en autoimmun bakgrund misstänkts. Hörnstenen i SLE-diagnostiken är ANA-test, för att påvisa cirkulerande antinukleära antikroppar. I enstaka studier har man tidigare hos vissa hundar med SLO kunnat påvisa ANA. Syftet med den här studien har varit att göra ANA-test på hundar med symmetrisk kloavlossning och SLO, samt att genom journalstudier beskriva hur sjukdomen ser ut i Sverige idag. Hundar provtagna och testade för ANA är sju bearded collies, fem riesenschnauzer, tre Rhodesian ridgeback och en toypudel samt tolv kontrollhundar av raserna bearded collie, riesenschnauzer och Rhodesian ridgeback. Samtliga hundar var negativa för ANA. Detta tillsammans med uppgifter från litteraturen leder till slutsatsen att ANA-test vid symmetriska kloproblem utan tecken på systemisk sjukdom har begränsat diagnostiskt värde. I journalstudien har framförallt behandling och behandlingsresultat undersökts. Tjugofem svenska hundar med SLO och symmetrisk kloavlossning inkluderades, hos 14 av dessa bedömdes behandlingsresultatet ge bra effekt, medan en hund avlivades på grund av kloproblemen. Många hundar fick en kombination av olika behandlingar, bytte behandling eller ändrade dos. Fettsyror och steroider var vanliga behandlingar med 22 respektive 11 fall. Andra använda läkemedel var pentoxifyllin samt azathioprin. Sekundärinfektioner i klo och klofals var vanligt och 18 hundar blev behandlade med antibiotika initialt. Enligt journalstudien framkom att fettsyror ofta ger ett bra behandlingsresultat samt låg förekomst av bieffekter, varför detta kan anses vara ett bra förstahandsval för behandling av symmetrisk kloavlossning. Vid uteblivet, eller otillräckligt, behandlingssvar kan dock behandlingen behöva ändras/kompletteras. Behandlingen är ofta livslång och recidiv kan trots detta ses.Symmetrical lupoid onychodystrophy, SLO, was first described in the mid nineties. The disorder is characterized by all claws being sloughed during a short period of time without concurrent systemic signs of disease. The underlying cause for the disease is yet unknown, but due to similar histological findings, such as for systemic lupus erythematosus, SLE and for cutaneous lupus erythematosus, LE, an autoimmune background has been suspected. The key to diagnosing SLE is ANA-testing for detecting circulating antinuclear antibodies. In a few previous studies, a small number of dogs with SLO have been ANA positive. This study’s aims are to test for ANA in dogs with symmetrical sloughing of the claws and SLO, and through studies of patient charts, to formulate a description of the disorder in Sweden today. The dogs tested for ANA included seven Bearded Collies, five Giant Schnauzers, three Rhodesian Ridgebacks and one Toy Poodle. Twelve dogs were used as controls, including the following breeds: Bearded Collies, Giant Schnauzers and Rhodesian Ridgebacks. All dogs tested negative for ANA. These results, together with information from the literature, leads to the conclusion that ANA testing in symmetrical claw disorders without signs of systemic disease has limited diagnostic value. In the case report, in particular different therapies and the outcome of treatment have been studied. Twenty-five Swedish dogs with SLO and symmetric claw disorders were included; fourteen of these were considered to have good response after medical treatment, while one dog had to be euthanized as a result of the claw disorder. In many cases treatments were changed, doses were altered or a combination of different therapies was given. Orally administered fatty acids and steroids were commonly used as treatments for 22 and 11 cases respectively. Other drugs used were pentoxifylline and azathioprine. Secondary infection of the claw and claw fold were common and 18 dogs were given initial antimicrobial treatment. According to the case study the results of treatments using fatty acids is often good and has little adverse side effects, which is why this may be considered a good first choice for the treatment of symmetrical claw disorders. In the case of no response, or an inadequate response, however, the treatment might need to be changed or other drugs added to control the disorder. The treatment is often lifelong but relapses may occur

Pan-cancer analysis of pre-diagnostic blood metabolite concentrations in the European Prospective Investigation into Cancer and Nutrition

Background: Epidemiological studies of associations between metabolites and cancer risk have typically focused on specific cancer types separately. Here, we designed a multivariate pan-cancer analysis to identify metabolites potentially associated with multiple cancer types, while also allowing the investigation of cancer type-specific associations. Methods: We analysed targeted metabolomics data available for 5828 matched case-control pairs from cancer-specific case-control studies on breast, colorectal, endometrial, gallbladder, kidney, localized and advanced prostate cancer, and hepatocellular carcinoma nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. From pre-diagnostic blood levels of an initial set of 117 metabolites, 33 cluster representatives of strongly correlated metabolites and 17 single metabolites were derived by hierarchical clustering. The mutually adjusted associations of the resulting 50 metabolites with cancer risk were examined in penalized conditional logistic regression models adjusted for body mass index, using the data-shared lasso penalty. Results: Out of the 50 studied metabolites, (i) six were inversely associated with the risk of most cancer types: glutamine, butyrylcarnitine, lysophosphatidylcholine a C18:2, and three clusters of phosphatidylcholines (PCs); (ii) three were positively associated with most cancer types: proline, decanoylcarnitine, and one cluster of PCs; and (iii) 10 were specifically associated with particular cancer types, including histidine that was inversely associated with colorectal cancer risk and one cluster of sphingomyelins that was inversely associated with risk of hepatocellular carcinoma and positively with endometrial cancer risk. Conclusions: These results could provide novel insights for the identification of pathways for cancer development, in particular those shared across different cancer types