Uterine inflammation after breeding is considered necessary for the clearance of excess semen and debris from the uterus. A subpopulation of mares fails to clear the inflammation in a timely fashion, and develops a persistent breeding induced endometritis (PBIE). Experiments were preformed to evaluate correlations of PBIE to endometrial quality and age. Mares of advanced age and poor endometrial quality had a higher incidence of PBIE. In addition, mares fluctuated in susceptibility to PBIE from one season to the next. The uterine inflammatory gene expression in susceptible and resistant mares within the first 24 hours after breeding was investigated. The peak endometrial cytokine gene expression occurred 6 hours after insemination, and susceptible mares were found to have a reduced response of the inflammatory modulating cytokines during this time. Intrauterine accumulation of the inflammatory byproduct nitric oxide (NO) was investigated in resistant and susceptible mares within the first 24 hours after breeding. Susceptible mares had an increase in NO accumulation over time, whereas NO accumulation in resistant mares remained relatively constant. The effects of immunomodulators on uterine inflammatory response and nitric oxide accumulation in susceptible mares was investigated. Immunomodulators decreased expression of the pro-inflammatory cytokine interleukin-1β and nitric oxide accumulation. In conclusion, endometrial quality and age are indicators of susceptibility to PBIE, and susceptibly can change from year to year. Six hours after breeding is a critical time for the development of PBIE, and susceptible and resistant mares have differential endometrial inflammatory gene expression, with susceptible mares appearing to have a defect in the inflammatory modulating immune response. Finally, treatment with immune modulators alters the IL1β gene expression and intrauterine nitric oxide accumulation, which may help to explain how they act to reduce inflammation during PBIE.

Studies described in this thesis were performed to investigate associations among season, diet, pituitary pars intermedia dysfunction (PPID) and blood concentrations of adrenocorticotropic hormone (ACTH), insulin, glucose, and leptin in horses. In the first study, higher ACTH concentrations were detected in horses affected with PPID. A seasonal increase in plasma ACTH concentration was detected in the late summer and early fall, but PPID did not affect the timing or duration of this increase. Pasture grazing raised glucose and insulin concentrations with a peak in September, at the same time that horses had higher ACTH concentrations, and this convergence of risk factors may raise the risk of laminitis. All of the horses included in this study were from the same farm. The second study was performed to determine whether horses from different locations within the same region exhibited the same seasonal increase in ACTH concentrations. Results of this study indicate that the seasonal increase in plasma ACTH concentrations occurs in horses from different farms with varying management practices. The third study investigated the effects of season on plasma leptin concentrations in the horses from the first study. We hypothesized that higher leptin concentrations would be detected in advance of the seasonal increase in plasma ACTH concentrations. Results did not support our hypothesis because leptin concentrations increased after ACTH concentrations peaked in September. Our findings suggest that the seasonal increase in ACTH concentrations induced leptin resistance, which might facilitate weight gain in the autumn. Alternatively, leptin concentrations increased as a result of weight gain or change in body fat composition. In summary, season appears to signal upregulation of the hypothalamic-pituitary-adrenal axis in horses, in an effort to prepare for winter. This upregulation is retained in horses with PPID, a disorder associated with loss of dopaminergic inhibition to the pars intermedia of the pituitary. The seasonal rise in plasma ACTH concentrations is followed by an increase in leptin concentrations, which suggests the development of leptin resistance or an increase in adiposity.

Two types of placentitis were studied: ascending and nocardioform placentitis. Although the first diagnosis of nocardioform placentitis was made three decades ago, little is known about the disease, due to the lack of an experimental model. In attempt to develop a research model, Crossiela equi was inoculated through intrauterine, intravenous, intrapharyngeal, and oral routes, but none of the routes resulted in nocardioform placentitis. This may indicate that unidentified factors may play a role in disease pathogenesis and that simple presence of bacteria is not sufficient to induce nocardioform placentitis. The second and major component of this dissertation involved the identification of diagnostic markers for placentitis. Because ascending bacterial placentitis is readily and predictably induced using existing experimental models, this model was used to identify diagnostic markers for placentitis in maternal plasma and fetal fluids. Three potential biomarkers were examined: acute phase inflammatory proteins, steroid hormones produced by the fetoplacental unit, and protein composition of the fetal fluids. Of the three acute phase proteins investigated, serum amyloid A and haptoglobin but not fibrinogen increased in association with experimentally induced ascending placentitis. Androgens and progestins appear to be poor markers for placentitis. Serum estradiol 17β concentrations were reduced in mares with experimentally induced placentitis and appear to be a good marker for placentitis in mares. Different methods were used to study the protein composition of the fetal fluids. Alpha-fetoprotein was characterized as a major protein present in the equine fetal fluids, and this protein was elevated in plasma of mares with placentitis. In another study, using a high-throughput proteomic technique several new proteins were characterized in the amniotic and allantoic fluids of mares carrying normal pregnancies, and several previously uncharacterized proteins were detected in the allantoic fluid of mares with placentitis. Three secreting proteins were elevated in allantoic fluid of mares with experimentally induced ascending placentitis.

Laminitis is a crippling disease of horses that can result in chronic lameness and debilitation, and sometimes warrants euthanasia. It is a complication of inflammatory conditions such as gastrointestinal disease, and also occurs in obese, insulin-resistant horses with Equine Metabolic Syndrome (EMS). Inflammation and insulin resistance are risk factors for laminitis, and these mechanisms might converge to induce laminitis in susceptible animals. Systemic inflammation is often attributed to endotoxemia, although circulating endotoxin concentrations are not commonly measured in the clinical setting. Although a theoretic basis exists for endotoxemia in the pathogenesis of laminitis, administration of endotoxin alone does not induce the condition. This could be related to differences between experimental models and naturally occurring disease. Studies presented in this dissertation address the overall hypothesis that systemic inflammation causes laminitis and new experimental models can be developed to better represent clinical disease. Associations between systemic inflammation and laminitis were first established by measuring blood inflammatory cytokine expression during a laminitis induction model. A clinically relevant endotoxin model that induced laminitis was then sought, but endotoxin administration alone was insufficient to cause laminitis and endotoxin tolerance developed. Endotoxemia was therefore evaluated in conjunction with predisposing factors such as obesity. In horses with EMS, endotoxin infusion caused exaggerated inflammatory responses, and derangements in glucose homeostasis were more pronounced. Laminitis, however, did not develop. Repeated inflammatory events are implicated in the pathogenesis of sepsis-associated organ failure, so a final study was performed to test whether preexisting endotoxemia increased the risk of laminitis during subsequent carbohydrate overload-induced systemic inflammation. This did not occur, however systemic inflammation was more pronounced in horses that developed laminitis compared to non-responders, and tissues rather than circulating leukocytes appeared to be the major source of inflammatory mediators. Our results do not support a role for endotoxin as the causal agent of laminitis, even when combined with predisposing factors. Tissues appear to be an important source of inflammatory mediators, therefore their role in laminitis should be further characterized. Additionally, future investigations should determine whether exaggerated inflammatory responses and loss of glycemic control increase the risk of laminitis in horses with EMS.

Frontal plane slab fractures account for the majority of third carpal bone (C3) fractures in performance horses. Treatment is stabilization with an AO cortical screw. Complications are fragment splitting, fragment spinning, and irritation of dorsal soft tissue structures. A novel, headless, cannulated screw with interlocking threads (the Headless Compression Screw Fastener, HCSF) has been developed to resist multidirectional forces. Simulated C3 slab fractures were created in nine paired equine carpi. HCSF or AO cortical screws were loaded in shear to failure. Stiffness, maximum load to failure, and yield load was assessed in linear mixed models. No significant difference was detected in maximum load to failure, stiffness, or yield load. Mode of failure was screw bending in all specimens. The HCSF successfully repaired simulated third carpal bone fractures. The design eliminates counter sinking. There was no significant difference compared to the cortical screws. These results promote clinical application.

Degenerative joint disease, or osteoarthritis, is a major cause of lameness and morbidity in horses, humans, and dogs. There are no truly satisfactory cures for this widespread problem and current treatments all have limitations or unwanted side effects. New cell-based strategies to repair joint surface lesions have generated a high level of interest, but have yet to achieve the full restoration of articular cartilage structure and function. Currently used therapy cells include autologous chondrocytes and adult mesenchymal cells such as bone marrow derived cells and adipose derived cells. Unfortunately, the resultant repair tissue is biomechanically inferior fibrocartilage. A critical gap in knowledge in this regard is a limited understanding of the specific cellular phenotype of normal, robust articular chondrocytes. This thesis examines the global mRNA transcriptome of equine articular cartilage to test the hypothesis that adult articular chondrocytes have a unique gene expression profile. In the first part of the study, RNA-sequencing was used to compare the mRNA transcriptome of normal adult articular cartilage with five other cartilaginous tissues. From these comparisons, locus level gene expression and alternative splicing patterns have been identified that clearly distinguish articular cartilage. In the second part of the study, fetal (interzone, cartilage anlagen chondrocytes, dermal fibroblasts) and adult (bone marrow derived, adipose derived, articular chondrocytes, dermal fibroblasts) primary cells were grown in culture and stimulated to differentiate into chondrocytes. The chondrogenic differentiation potential as assessed by matrix proteoglycan and the expression of cartilage biomarker genes was highly variable among cell types. Together, these results advance our understanding of the specific phenotype of articular chondrocytes and the potential of prospective therapeutic progenitor cells to differentiate into articular chondrocytes. This new knowledge will improve efforts to optimize cell-based therapies for osteoarthritis and the repair of joint cartilage lesions.

Intra-articular glucocorticoid injections are commonly used to treat synovitis and osteoarthritis in horses. These agents are highly effective at relieving pain, swelling, and other symptoms of joint inflammation. The drugs also have therapeutic benefits by down regulating the expression of cytokines and protease enzymes that participate in the degradation of articular cartilage. However, detrimental effects on chondrocyte function and cell viability that is independent of osteoarthritis pathogenesis have been described and linked to glucocorticoid use. These side effects are both drug- and dose-dependent. This study tested the hypothesis that manufacture recommended dosage levels of methylprednisolone, betamethasone, and triamcinolone that are widely used in equine clinical practice are cytotoxic to articular chondrocytes. Drug-induced chondrocyte cytotoxicity was evaluated in monolayer cultures, cartilage explants, and equine fetlock joints. Total RNA was isolated from control and IL-1β stimulated primary chondrocytes and synoviocytes in culture. Changes in steady state mRNA for targeted gene transcripts related to inflammation and normal cell function were measured using reverse transcription and quantitative PCR. Inducible nitric oxide synthase activity was evaluated using nitrite production. Drug-induced chondrocyte cytotoxicity occurred at drug dosage levels frequently used in equine clinical practice. Both drug- and dose-dependent effects on chondrocyte and synoviocyte gene expression were observed. Maximum anti-inflammatory activities for the glucocorticoids were observed at in vitro concentrations below manufacturer-recommended levels. Results from this study suggest that lower glucocorticoid dose ranges for intra-articular therapy in horses should be validated to maximize the ratio of their therapeutically beneficial anti-inflammatory efficacy against detrimental effects on cell function and viability.

Progesterone in the mare declines to almost undetectable concentrations in late gestation. It’s metabolized into several pregnanes, some circulating at very high concentrations. Although the function of many pregnanes remains unclear, 5α-dihydroprogesterone and allopregnanolone are bioactive. Measurements of pregnanes in late gestation are typically by immunoassay, although results are confounded by cross-reactivity with related pregnanes. Conversely, liquid chromatography tandem mass spectrometry (LC-MS/MS) allows differentiation of individual pregnanes. The purposes of these studies were: 1) to evaluate the ability of a 5α-reductase inhibitor, dutasteride, to alter pregnane metabolism and pregnancy outcome, 2) to evaluate changes in target pregnanes in late gestation by LC-MS/MS in mares with ascending placentitis, and 3) compare immunoassay and LC-MS/MS detection of pregnanes in late gestation. Our findings suggest that dutasteride significantly altered pregnane metabolism without effects on pregnancy outcome. Pregnane measurement by LC-MS/MS resulted in a significant (p<0.05) differences in assay results, while correlation was observed between immunoassay measurements and actual progesterone concentrations by LC-MS/MS. These studies demonstrate the complexity of pregnane metabolism in late gestation in the mare and the necessity of LC-MS/MS to detect specific changes that immunoassays cannot differentiate.

The mare experiences a transient innate immune response to breeding, the resolution of which is crucial for optimal fertility. The majority of mares are able to modulate this inflammation in a timely fashion, but a subpopulation exists which fail to do so and are considered susceptible to persistent breeding-induced endometritis (PBIE). Seminal plasma has been shown to modulate aspects of this inflammation. Recently, two seminal plasma proteins have garnered interest for their immune modulating properties: cysteine-rich secretory protein-3 (CRISP-3) and lactoferrin. These proteins have been found to alter the binding between sperm and neutrophils based on sperm viability in vitro, but minimal work has evaluated their effect on endometrial mRNA expression of cytokines and inflammation in response to breeding. Experiments were performed to analyze the expression of equine CRISP-3. Found to be primarily synthesized in the ampulla of the vas deferens and to a lesser extent in the vesicular gland, CRISP-3 expression was only seen in the postpubertal stallion. Due to the effect of sperm viability on protein function in vitro, varying sperm populations were analyzed for their effect on gene expression in the uterus. It was determined that viable sperm suppressed the gene expression of the inflammatory modulating cytokine interleukin-6 (IL-6) in comparison to dead sperm. Next, the effect of CRISP-3 and lactoferrin on endometrial gene expression in the normal and susceptible mare was investigated. Neither protein had a significant effect on the mRNA expression of inflammatory cytokines in the normal mares at six hours post-breeding. In contrast, lactoferrin was found to significantly suppress the expression of the pro-inflammatory cytokine tumor necrosis factor (TNF)-α in susceptible mares. Due to this, lactoferrin was further analyzed as an immunomodulant for the treatment of PBIE. Susceptible mares were infused with varying doses of lactoferrin at six hours post-breeding. Although not in a dose-dependent fashion, lactoferrin was found to decrease both fluid retention and neutrophil migration, in addition to suppressing the expression of the pro-inflammatory cytokine interferon gamma (IFNγ) and increasing the gene expression of the anti-inflammatory cytokine interleukin-1 receptor antagonist (IL-1RN). In conclusion, CRISP-3 expression occurs in secretory aspects of the male reproductive tract, and appears to be up regulated after sexual maturation. Viability of spermatozoa affects the immune response to breeding and should be taken into consideration for experimental design and interpretation of data. The seminal plasma proteins CRISP-3 and lactoferrin have minimal effect on endometrial gene expression in normal mares, but lactoferrin suppresses the expression of TNF in susceptible mares. Finally, lactoferrin was found to function as a potent anti-inflammatory for the persistent inflammation seen in susceptible mares when administered post-breeding. This protein should be further investigated as a potential therapeutic for the treatment of persistent breeding-induced endometritis.

Although Rhodococcus equi (R. equi), previously known as Corynebacterium equi, was first isolated from pneumonic foals almost a century ago, it remains the most common cause of subacute or chronic granulomatous bronchopneumonia in foals. While the majority of foals exposed to R. equi develop a protective immune response (regressors), others exhibit a unique susceptibility to infection (progressors). The determinants for either outcome are not completely understood. Therefore, current diagnostic and preventive measures are suboptimal and require betterment. In light of this current need, we hypothesized that immunoglobulin G subisotype T [IgG(T)] against the virulence-associated protein A (VapA) of R. equi, and whole blood cytokine expression profile of foals predict the outcome of infection and can be used as diagnostic markers of clinical disease. Further, we hypothesized that the use of R. equi hyperimmune plasma (HIP) decreases severity of disease in naturally infected foals, playing an important role in disease prevention in the field. Lastly, we hypothesized that specific anti-Rhodococcus equi pili antibodies passively acquired by foals via colostrum after immunization of pregnant mares with a Rhodococcus equi pili-based candidate vaccine will confer protection against induced disease, and therefore have an immediate impact on R. equi pneumonia prophylaxis. The objectives of this study were: (1) to describe the humoral immune response of progressor and regressor foals to R. equi following experimental challenge and natural infection, (2) to compare the cytokine and cell-marker expression profile in whole blood of progressor and regressor foals after challenge, (3) to evaluate the Vap-A specific IgG profile of a commercially available HIP product and its value as a prophylactic tool on an endemic farm, and (4) to evaluate the efficacy of a vaccine based on the Rhodococcus equi pili (Rpl). Although the IgG(T) response of progressor foals after challenge or following natural infection tended to be more pronounced than that observed in regressor foals, its performance as a diagnostic test for predicting disease outcome was poor. Likewise, whole blood cell-marker and cytokine expression profiles of progressor and regressor foals were not significantly different, undermining its reliability as a diagnostic tool. Evaluation of the association of HIP VapA specific IgG profile and rhodococcal disease outcome in the field resulted in the conclusion that progressor foals received significantly less VapA specific IgG, suggesting that HIP may have provided some protection to regressor foals. Although HIP appeared to have provided some protection against clinical pneumonia, Rpl maternally-derived IgG failed to confer any advantage to foals born from vaccinated mares. The Rpl candidate vaccine failed to confer protection to foals after challenge, and did not decrease disease severity in comparison to a control group. In summary, the results of this study do not support the use of VapA specific IgG(T) or whole blood cytokine expression profile as predictors of disease outcome. Further, our results suggest a positive effect of HIP on disease outcome. Lastly, the presence of systemic and local Rpl antibodies was not protective in foals.