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D C Archer - One of the best experts on this subject based on the ideXlab platform.
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idiopathic focal Eosinophilic Enteritis ifee an emerging cause of abdominal pain in horses the effect of age time and geographical location on risk
PLOS ONE, 2014Co-Authors: D C Archer, Deborah A. Costain, Chris SherlockAbstract:Background: Idiopathic focal Eosinophilic Enteritis (IFEE) is an emerging cause of abdominal pain (colic) in horses that frequently requires surgical intervention to prevent death. IFEE lesions were first identified in the late 1990’s and the incidence of this form of colic has continued to increase in certain equine hospital populations. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. In addition, the aetiology of this condition and methods of possible prevention are also currently unknown. Based upon a UK equine hospital population the aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on the risk process. Methodology/Principal Findings: A retrospective, nested case-control study was undertaken. Data were extracted and pertained to 85 observed IFEE cases and 848 randomly selected controls (non-cases) admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Spatial clustering was investigated via K-function analysis, and generalised additive models (GAM's) were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of ‘residual’ risk over the study region. The relative risk of IFEE increased over the study period (p=0.001) and a seasonal pattern was evident (p<0.01) with greatest risk of IFEE being identified between the months of July-November. Age was found to be a contributory factor (p<0.001) with IFEE risk decreasing with increasing age and younger (0 - 5 years old) horses being at greatest risk. Spatial clustering of cases was significantly different to that of controls (p<0.001) over a wide range of spatial scales (from 4km to at least 50km). The mapped surface estimate exhibited significantly atypical sub-regions (p<0.001) with increased IFEE risk in horses residing in the north-west of the study region. Conclusions/Significance: IFEE exhibits both spatial and temporal clustering and is more likely to occur in younger horses. This evidence-based information can be used by clinicians to identify horses at increased risk of IFEE; to provide clues as to the aetiology of the disease and to justify further research into environmental factors that may account for the observed spatial and temporal clustering.
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characterisation of the inflammatory reaction in equine idiopathic focal Eosinophilic Enteritis and diffuse Eosinophilic Enteritis
Equine Veterinary Journal, 2008Co-Authors: P E Makinen, D C Archer, Keith E Baptiste, A Malbon, C J Proudman, Anja KiparAbstract:REASONS FOR PERFORMING STUDY: Idiopathic focal Eosinophilic Enteritis (IFEE) and diffuse Eosinophilic Enteritis (DEE) are primary Eosinophilic intestinal conditions without a known cause that are associated with an increasing number of surgical colic cases. Histology may be helpful in defining disease aetiology and pathogenesis. OBJECTIVES: To characterise further the inflammatory infiltrate in equine IFEE and to compare the condition with DEE. METHODS: Twenty-three IFEE cases and 5 DEE cases were examined by light microscopy including immunohistology to identify infiltrating leucocytes. Inflammatory infiltrates in mucosa and submucosa were characterised in IFEE lesions (Group 1), the intestine distant from the lesions in IFEE (Group 2) and DEE (Group 3). RESULTS AND CONCLUSIONS: IFEE lesions represented an accumulation of leucocytes in submucosa and muscularis, with dominance of eosinophils and macrophages and smaller numbers of lymphocytes, plasma cells and neutrophils. T cells represented the dominant lymphocytes. The mucosa overlying the lesion and both mucosa and submucosa in IFEE nonlesion sites and in DEE exhibited a similar composition, with different prevalence of various cell types. Macrophages were significantly more prevalent in the mucosal and submucosal infiltrates in IFEE nonlesion sites than in DEE, and lymphocytes significantly more prevalent in the mucosa in DEE than in IFEE nonlesion sites. The findings confirm IFEE as a primary Eosinophilic intestinal disorder and indicate that IFEE represents a focally exacerbated inflammatory reaction in horses with DEE, possibly due to functional changes in the macrophage and T cell components, with subsequent excessive recruitment of both eosinophils and macrophages.
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obstruction of equine small intestine associated with focal idiopathic Eosinophilic Enteritis an emerging disease
Veterinary Journal, 2006Co-Authors: D C Archer, Barrie G Edwards, D F Kelly, N P French, C J ProudmanAbstract:Idiopathic focal Eosinophilic Enteritis (IFEE) is a rare disease in the horse and few cases have been reported in the literature. The objective of this paper was to describe the clinical, surgical, histological features and post-operative progress of 12 horses with IFEE, a disease that had not been identified in the authors' hospital population prior to 2000. Diagnosis of IFEE was made at laparotomy and confirmed by histological examination of resected abnormal small intestine. In all 12 horses colic was associated with jejunal obstruction involving visibly striking and palpably thickened serosal plaques or circumferential constrictions. Surgical resection of affected intestine was performed in 10 horses, of which seven completely recovered. In one horse, on which surgical resection was not performed, ingesta re-obstructed post-operatively at one of the lesions. Histological examination of resected intestines revealed, in all cases, severe transmural Enteritis in which Eosinophilic leucocytes were the predominant inflammatory cells. No helminths were identified and the cause of this lesion is not known. IFEE is an uncommon but significant cause of small intestinal obstruction for which surgical resection can be curative. The gross lesions may be under-recognised and histology is essential for diagnosis.
Chris Sherlock - One of the best experts on this subject based on the ideXlab platform.
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RESEARCH ARTICLE Idiopathic Focal Eosinophilic Enteritis (IFEE), an Emerging Cause of Abdominal Pain in Horses: The Effect of Age, Time and Geographical Location on Risk
2016Co-Authors: Debra C. Archer, Deborah A. Costain, Chris SherlockAbstract:Background: Idiopathic focal Eosinophilic Enteritis (IFEE) is an emerging cause of abdominal pain (colic) in horses that frequently requires surgical intervention to prevent death. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. The aetiology of this condition and methods of possible prevention are currently unknown. The aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on risk. Methodology/Principal Findings: A retrospective, nested case-control study was undertaken using data from 85 IFEE cases and 848 randomly selected controls admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Generalised additive models (GAMs) were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of ‘residual ’ risk over the study region. The relative risk of IFEE increased over the study period (p50.001) and a seasonal pattern was evident (p,0.01) with greatest risk of IFEE being identified between the months of July and November. IFEE risk decreased with increasing age (p,0.001) with younger (0–5 years old) horses being at greatest risk. The mapped surface estimate exhibited significantly atypical sub-regions (p,0.001) with increased IFEE risk in horses residing in the North-West of the study region. Conclusions/Significance: IFEE was found to exhibit both spatial and temporal variation in risk and is more likely to occur in younger horses. This information may help to identify horses at increased risk of IFEE, provide clues about the aetiology of this condition and to identify areas that require further research
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idiopathic focal Eosinophilic Enteritis ifee an emerging cause of abdominal pain in horses the effect of age time and geographical location on risk
PLOS ONE, 2014Co-Authors: D C Archer, Deborah A. Costain, Chris SherlockAbstract:Background: Idiopathic focal Eosinophilic Enteritis (IFEE) is an emerging cause of abdominal pain (colic) in horses that frequently requires surgical intervention to prevent death. IFEE lesions were first identified in the late 1990’s and the incidence of this form of colic has continued to increase in certain equine hospital populations. The epidemiology of IFEE is poorly understood and it is difficult to diagnose pre-operatively. In addition, the aetiology of this condition and methods of possible prevention are also currently unknown. Based upon a UK equine hospital population the aims of this study were to investigate temporal and spatial heterogeneity in IFEE risk and to ascertain the effect of horse age on the risk process. Methodology/Principal Findings: A retrospective, nested case-control study was undertaken. Data were extracted and pertained to 85 observed IFEE cases and 848 randomly selected controls (non-cases) admitted to a UK equine hospital for exploratory laparotomy to investigate the cause of colic over a 10-year period. Spatial clustering was investigated via K-function analysis, and generalised additive models (GAM's) were used to quantify temporal and age effects on the odds of IFEE and to provide mapped estimates of ‘residual’ risk over the study region. The relative risk of IFEE increased over the study period (p=0.001) and a seasonal pattern was evident (p<0.01) with greatest risk of IFEE being identified between the months of July-November. Age was found to be a contributory factor (p<0.001) with IFEE risk decreasing with increasing age and younger (0 - 5 years old) horses being at greatest risk. Spatial clustering of cases was significantly different to that of controls (p<0.001) over a wide range of spatial scales (from 4km to at least 50km). The mapped surface estimate exhibited significantly atypical sub-regions (p<0.001) with increased IFEE risk in horses residing in the north-west of the study region. Conclusions/Significance: IFEE exhibits both spatial and temporal clustering and is more likely to occur in younger horses. This evidence-based information can be used by clinicians to identify horses at increased risk of IFEE; to provide clues as to the aetiology of the disease and to justify further research into environmental factors that may account for the observed spatial and temporal clustering.
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Geographic locations, x = (x1, x2) = (Easting, Northing), of case and control horses.
2014Co-Authors: Debra C. Archer, Deborah A. Costain, Chris SherlockAbstract:The point map depicts the geographical location of the 85 cases (red triangles) of idiopathic focal Eosinophilic Enteritis (IFEE) and 848 randomly selected controls (‘+’) in the present study. The green circle shows the location of the Philip Leverhulme Equine Hospital (PLEH).
Paul Prociv - One of the best experts on this subject based on the ideXlab platform.
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THE MOST WIDESPREAD of all hookworm
2010Co-Authors: Juergen K L, Paul ProcivAbstract:recent Research years, the realisation that A. caninum can cause human gut disease 1,2 has sparked renewed interest in its biology and epidemiology. In north-eastern Australia, human Eosinophilic Enteritis has been diagnosed relatively frequently, and A. caninum infection accounts for most cases. Although only single worms have ever been recovered from patients, and egg production has never been detected, 1,2 anthelmintic treatment leads to a rapid clinical response
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acasp a gene encoding a cathepsin d like aspartic protease from the hookworm ancylostoma caninum
Biochemical and Biophysical Research Communications, 1996Co-Authors: Stephen A Harrop, Paul Prociv, Paul J. BrindleyAbstract:Abstract Intestinal infection with the zoonotic hookworm Ancylostoma caninum can provoke human Eosinophilic Enteritis. A cDNA was isolated from A. caninum, using an oligonucleotide primer designed to hybridize to the region encoding the consensus, catalytic site residues D 32 TGSSNLW of aspartic proteases. This novel cDNA encoded an aspartic protease zymogen of 422 amino acids, exhibiting 47% identity to the lysosomal aspartic protease of Aedes aegypti, 46% identity to the aspartic protease of Schistosoma japonicum, and 48.5% to human cathepsin D. Its deduced structure differed from that of cathepsin D in the loop 2 “flap,” which holds the substrate at the active site, and by the presence of a COOH-terminal extension of ∼30 residues.
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Eosinophilic Enteritis in northeastern australia pathology association with ancylostoma caninum and implications
The American Journal of Surgical Pathology, 1995Co-Authors: Neal I Walker, Alex Loukas, John Croese, Andrew D Clouston, M Parry, Paul ProcivAbstract:While Eosinophilic gastroEnteritis is considered a rare condition, Eosinophilic Enteritis without gastric involvement is quite common in northeastern Australia. We present 79 patients with biopsy-proven Eosinophilic Enteritis, 70 seen since 1987. In 10 patients, Eosinophilic Enteritis was associated with infection by single, sexually immature, adult hookworms, most positively identified as the common dog hookworm Ancylostoma caninum. An additional 22 patients (of 34 tested) had serological evidence of A. caninum exposure. The essential pathology, i.e., edema and Eosinophilic infiltration of the gut wall, ascites, and regional lymphadenopathy, was identical to that seen in Eosinophilic gastroEnteritis. Additional, more specific features included pathological reactions centered on attached worms, mucosal alterations and ulcers considered to be hookworm bite sites, and submucosal and lymph node granulomas with central eosinophil degranulation and degradation products. Since A. caninum has an almost worldwide distribution, it is probable that A. caninum-induced Eosinophilic Enteritis occurs outside Australia. We show that the worm is easily overlooked in pathological specimens and that care is required to preserve worms intact for specific parasitological identification. The clinical and pathological features were similar to those seen in another human enteric helminthic zoonosis, anisakiasis. The possibility that there are yet other undiscovered intestinal zoonoses remains.
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secretion of cysteine proteinase activity by the zoonotic hookworm ancylostoma caninum
American Journal of Tropical Medicine and Hygiene, 1994Co-Authors: Andrew J Dowd, Alex Loukas, Paul Prociv, John P Dalton, Paul J. BrindleyAbstract:Abstract The zoonotic hookworm, Ancylostoma caninum, probably induces human Eosinophilic Enteritis by inducing allergic responses to its secretions. This species is already known to secrete metalloproteinases, but in other parasites, cysteine proteinases are involved in pathogenesis. We studied somatic extracts of A. caninum adults and infective larvae and adult excretory/secretory (ES) antigens for cysteine proteinase activity using fluorogenic peptide substrates and by gelatin and fluorogenic substrate polyacrylamide gel electrophoresis. Proteolytic activity was observed against the cathepsins L and B-specific substrate Z-phe-arg-AMC, against the plasmin substrate Boc-val-leu-lys-AMC, and against gelatin. The Z-phe-arg-AMC-hydrolyzing activity in ES antigens and in adult extracts was enhanced up to 15-fold by the reducing agent dithiothreitol (DTT), but was totally blocked by specific inhibitors of cysteine proteinases, including the peptidyl diazomethyl ketone Z-phe-ala-CHN2, E-64, leupeptin, and N-ethylmaleimide. In a similar fashion, gelatinolytic activity in ES antigens detected using substrate gels was enhanced by the addition of reducing agents and inhibited by Z-phe-ala-CHN2 and E-64. The DTT-enhanced, Z-phe-arg-AMC-hydrolyzing activity in ES antigens was active over a wide pH range (pH 5–9). Similar cysteine proteinase activity to that detected in ES antigens was present in extracts of adult and infective larvae of A. caninum. Because the substrate Z-phe-arg-AMC was specifically hydrolyzed, and because this hydrolysis was totally blocked by cysteine proteinase-specific inhibitors, ES antigens and tissue extracts of A. caninum clearly possess cysteine proteinase activity. Furthermore, since the specific activity of Z-phe-arg-AMC-cleaving enzyme was up to five-fold higher in ES antigens than in soluble extracts of parasites, the cysteine proteinase is actively secreted by adult hookworms. This is the first demonstration of cysteine proteinases from hookworms and enlarges the range of potential allergens that may induce human Eosinophilic Enteritis.
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occult enteric infection by ancylostoma caninum a previously unrecognized zoonosis
Gastroenterology, 1994Co-Authors: John Croese, Alex Loukas, J P Opdebeeck, Paul ProcivAbstract:Background/Aims: Human disease caused by the canine hookworm Ancylostoma caninum and a high incidence of Eosinophilic Enteritis have been reported from northern Queensland, Australia. The aim of this study was to evaluate patients with unexplained abdominal pain and a possible association with cryptic infections by A. caninum . Methods: The clinical and demographic features of patients from this region with Eosinophilic Enteritis (group A1, n=42), obscure abdominal pain associated with (group A2, n=105) and without (group A3, n=84) blood eosinophilia were reviewed and sera were tested against A. caninum excretory-secretory antigens by enzyme-linked immunosorbent assay (ELISA) and Western blot. Four additional patients, two with confirmed A. caninum , had hookworm infection. Results: The level of dog ownership in these four groups was 79%–100%, higher than in the local population ( P P P Conclusions: We conclude occult human A. caninum infections are common and are characterized by Eosinophilic Enteritis and obscure abdominal pain with or without blood eosinophilia. The diagnosis can be confirmed by serology.
C I Melendezmercado - One of the best experts on this subject based on the ideXlab platform.
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Eosinophilic Enteritis in association with systemic lupus erythematosus
Lupus, 2009Co-Authors: J Jaimeshernandez, P Arandapeirera, C I MelendezmercadoAbstract:Eosinophilic gastroEnteritis (EGE) is an uncommon disease and has rarely been reported in association with connective tissue diseases as systemic lupus erythematosus. We report a 36-year-old woman who developed recurrent episodes of abdominal pain, nausea, vomiting and melena. Complete blood counts showed elevated eosinophil counts. Ultrasound and CT-scan images studies were significant for bowel wall thickening and ascites. The patient underwent an exploratory laparotomy with a mesenteric biopsy and appendectomy that showed eosinophil infiltration in the muscularis propria, establishing the diagnosis of EGE. The patient developed pleural effusions, with laboratory studies showing haemolytic anaemia, thrombocytopenia, positive antinuclear antibody and anticardiolipin antibodies. The patient was treated with high-dose systemic corticosteroid therapy, with successful resolution of symptoms. Three months later, she developed a new episode of abdominal pain defined as intestinal pseudo-obstruction that was resolved without complications.
Anja Kipar - One of the best experts on this subject based on the ideXlab platform.
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characterisation of the inflammatory reaction in equine idiopathic focal Eosinophilic Enteritis and diffuse Eosinophilic Enteritis
Equine Veterinary Journal, 2008Co-Authors: P E Makinen, D C Archer, Keith E Baptiste, A Malbon, C J Proudman, Anja KiparAbstract:REASONS FOR PERFORMING STUDY: Idiopathic focal Eosinophilic Enteritis (IFEE) and diffuse Eosinophilic Enteritis (DEE) are primary Eosinophilic intestinal conditions without a known cause that are associated with an increasing number of surgical colic cases. Histology may be helpful in defining disease aetiology and pathogenesis. OBJECTIVES: To characterise further the inflammatory infiltrate in equine IFEE and to compare the condition with DEE. METHODS: Twenty-three IFEE cases and 5 DEE cases were examined by light microscopy including immunohistology to identify infiltrating leucocytes. Inflammatory infiltrates in mucosa and submucosa were characterised in IFEE lesions (Group 1), the intestine distant from the lesions in IFEE (Group 2) and DEE (Group 3). RESULTS AND CONCLUSIONS: IFEE lesions represented an accumulation of leucocytes in submucosa and muscularis, with dominance of eosinophils and macrophages and smaller numbers of lymphocytes, plasma cells and neutrophils. T cells represented the dominant lymphocytes. The mucosa overlying the lesion and both mucosa and submucosa in IFEE nonlesion sites and in DEE exhibited a similar composition, with different prevalence of various cell types. Macrophages were significantly more prevalent in the mucosal and submucosal infiltrates in IFEE nonlesion sites than in DEE, and lymphocytes significantly more prevalent in the mucosa in DEE than in IFEE nonlesion sites. The findings confirm IFEE as a primary Eosinophilic intestinal disorder and indicate that IFEE represents a focally exacerbated inflammatory reaction in horses with DEE, possibly due to functional changes in the macrophage and T cell components, with subsequent excessive recruitment of both eosinophils and macrophages.