Latest News in Equine Laminitis
Laminitis is a common equine disease that causes significant pain and decreased mobility, and afflicts horses from many breeds, ages, backgrounds, and disciplines. The condition can be caused by limb overload, inflammation, or an endocrinopathy, and the result, no matter the cause, is impaired tissue integrity and inflammation of the epidermal and dermal lamellae connecting the hoof capsule to the distal phalanx. Case management can be difficult, and many laminitic horses are euthanized when their pain can’t be effectively controlled. Current treatment strategies focus on controlling pain and improving hoof stability, but new research may lead to better treatments and methods to reduce laminitis risk in some horses.
Using gene expression analysis to better understand laminitis
Researchers from the University of Pennsylvania School of Veterinary Medicine and the University of Florida Institute of Food and Agricultural Sciences collaborated to identify unknown pathways in cell stress and inflammatory responses in supporting limb laminitis, to enhance understanding about the disease process. Previous laminitis studies produced little information concerning genetics specific to hoof tissues, providing little understanding about the condition inside the hoof.
To carry out the Penn-UF study, researchers accessed the New Bolton Center Laminitis Discovery Database, which is an archive of data and sample sets collected from naturally occurring laminitis cases since 2008. Using this information, the scientists examined 36 archived tissues belonging to 20 Thoroughbred horses treated for laminitis. They used gene expression analysis to evaluate gene transcription changes in these horses. Some horses had healthy feet, some were early in the disease process, and some had advanced laminitis. The researchers identified three key findings about the laminitis disease process.
- Changes in keratin and metalloproteinases — Keratin is an important structural hoof component, and the researchers found that some keratin-related genes, and genes involved in regulating keratin manufacturing, started to degrade in the laminitis early stages, causing loss of appropriate lamellar mechanical function. Metalloproteinases are a class of enzyme that help maintain the cytoskeleton, and function to maintain balance, allowing the hoof to grow without breaking down under the horse’s weight. When these metalloproteinases become overactive, the hoof begins to lose structural integrity. Knowing more about how these important structural components function during laminitis will help researchers develop strategies to address these problems.
- Genes responsible for inflammation — When keratin degrades, the inside of the hoof becomes inflamed, and the study revealed a collection of genes that trigger this inflammatory response. This information will hopefully help scientists develop new laminitis therapies. Because of the genes involved, researchers believe that some human medications used to treat autoimmune disorders may help laminitic horses.
- Identifying biomarkers — Changes in gene expression in diseased tissue often cause changes in proteins, which can be detected in the blood as the disease progresses. The study found that specific proteins (i.e., biomarkers) that increase in humans after a traumatic brain injury were also increased in the laminitic horses’ samples. Physicians use these biomarkers to gain knowledge about a patient’s condition, and the researchers hope that they can also be used as a tool to monitor laminitis progression in horses.
These findings have allowed researchers to better understand laminitic episodes, and have provided some promising avenues for further research that will hopefully find new prevention and treatment strategies to address this debilitating disease.
Monitoring insulin to predict laminitis in ponies
Researchers from the Royal Veterinary College, in collaboration with the Waltham PetCare Science Institute, both in the UK, studied potential laminitis indicators and found that monitoring insulin concentrations in the blood can help predict laminitis in ponies. Endocrinopathic laminitis, which is the most common, is often associated with insulin disorders, and the research team investigated practical ways for veterinarians and owners to identify and measure predictors of this condition. The study included 374 ponies in the south of England who had never suffered from laminitis. The researchers weighed, physically examined, and collected samples from the ponies every six months for four years. Metabolic data included plasma concentrations of ACTH, adiponectin, triglycerides, and glucose. In addition, insulin was measured before and 60 minutes after oral administration of corn syrup.
The researchers found that by measuring insulin concentrations, they could identify ponies as low, medium, or high risk for future laminitis episodes.
- Low risk — Ponies classified as low laminitis risk had less than 21.6 uIU/mL before receiving corn syrup, and less than 53.4 uIU/mL after.
- Medium risk — Ponies classified as medium laminitis risk had 21.6 to 45.2 uIU/mL before receiving corn syrup, and 53.4 to 153 uIU/mL after.
- High risk — Ponies classified as high laminitis risk had greater than 45.2 uIU/mL before receiving corn syrup, and greater than 153 uIU/mL after.
During the four-year study, 70% of the high risk ponies developed laminitis, but only 6% of the low risk ponies developed laminitis. The researchers were surprised to find that ACTH concentrations were not a useful laminitis predictor. These findings can be applied clinically, and will hopefully help veterinarians identify patients at high risk for laminitis, so they can implement management strategies to decrease their risk.
These studies provide significant information to direct future research and help veterinarians identify horses and ponies at high risk for laminitis.
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