Equine pituitary pars intermedia dysfunction (PPID) typically occurs in horses older than 15 years of age and is characterized by hair coat abnormalities, muscle atrophy and decreased insulin sensitivity. The first objective of this research was to compare the rate of whole body protein metabolism and relative abundance of key factors in the signaling pathways associated with muscle protein synthesis and protein breakdown in response to feeding in Control and PPID horses. No differences (P > 0.05) were seen between the PPID and Control groups in whole-body protein metabolism or post-prandial activation of the muscle signaling pathways regulating skeletal muscle protein synthesis and breakdown. The second objective of this research was to determine if aged horses with PPID had reduced insulin sensitivity and alterations in the insulin-mediated signaling pathways in the skeletal muscle when compared to non-PPID, aged Control horses. Measures of insulin sensitivity and the activation of factors associated with protein synthesis and breakdown were similar between the PPID and Control groups (P > 0.05). Overall, insulin sensitivity and protein metabolism are similar between the PPID and Control groups. The studies suggest that abnormalities may exist as a function of advanced age rather than PPID status directly.

Senior horses (≥20 years) exhibit inflamm-aging, or chronic, low-grade inflammation that occurs systemically with aging, similarly to humans. Inflamm-aging has previously been characterized in the horse in circulation as well as specifically being mediated by lymphocytes and monocytes. In humans, inflamm-aging has been associated with increased morbidity and mortality. However, in the horse, relatively little about inflamm-aging is known regarding clinical effects or factors influencing severity. The contribution of lymphocytes to inflamm-aging of senior horses was examined, specifically through determining the relationships of inflamm-aging with various other health parameters, effects of seasonality, and the extent to which inflamm-aging can be modulated by anti-inflammatory phytonutrient curcumin. The overall hypothesis of this research is that lymphocyte-mediated inflamm-aging of the senior horse is associated with various factors including season, endocrine function, body composition, and nutritional status, and may be modulated by polyphenol curcumin. The effect of season on lymphocyte-mediated inflamm-aging was examined, and senior horses exhibited elevated inflammation compared to adult horse as expected, while also exhibiting changes in inflammatory cytokine production and gene expression throughout the year. In addition to season, pituitary pars intermedia dysfunction (PPID), a common endocrinopathy in senior horses that is associated with immunosuppression, was examined in a group of senior horses to determine any effects on degree of inflamm-aging. Results indicated no significant differences between age-matched PPID and non-PPID horses for lymphocyte-mediated inflammatory cytokine production or gene expression. The immunosuppressive aspect of PPID does not appear to be associated with the degree of lymphocyte-mediated inflammation of the aged horse. Additionally, an expansive correlative study was undertaken to determine relationships between inflamm-aging and basal nutritional status, body composition, age, and PPID within a similarly-managed senior horse population. Results showed various relationships between inflammatory markers and nutritional status, particularly yielding positive associations with serum folate and with serum fatty acids C22:2n6c and C22:5n3c. Inflammation was also associated with age itself but was not associated with body composition parameters and showed mild association with PPID (and serum inflammatory C-reactive protein). As a whole, this study demonstrates that nutritional status can be associated with inflammatory markers. Similarly, many phytonutrients have exhibited anti-inflammatory properties, which may be beneficial to the senior horse exhibiting inflamm-aging. Specifically, the effects of polyphenols including curcuminoids, resveratrol, quercetin, pterostilbene, and hydroxypterostilbene on lymphocyte production of inflammatory cytokines by senior horses were examined in vitro and found to significantly reduce inflammation similarly to common non-steroidal anti-inflammatory drugs. This study led to the in vivo investigation of the effectiveness of curcumin in modulating chronic inflammation of the senior horse. No significant differences were seen between groups receiving curcumin and placebo for the various inflammatory parameters, which may be due to the dose or low bioavailability of curcumin. As a whole, this research provides further understanding of factors associated with inflamm-aging of the senior horse.

Pituitary pars intermedia dysfunction (PPID) is one of the most common endocrine diseases affecting senior horses. PPID causes abnormally high concentrations of adrenocorticotropic hormone (ACTH) in the plasma and a very distinct, long, shaggy haircoat (hypertrichosis). At present, the recommended treatment for PPID is daily oral administration of pergolide mesylate. Due to the increased ACTH levels associated with PPID, it is commonly thought that these horses are immunosuppressed and at increased risk of opportunistic infections, although current research in this area is sparse. Additionally, it is not well-understood how treatment with Prascend® (pergolide tablets) affects endocrine measures other than ACTH and if it also impacts the immune response. To better understand how PPID influences endocrine and immune function in the horse, Non-PPID horses (n=10), untreated PPID horses (n=9), and PRASCEND-treated PPID horses (n=9) were followed over 15 months. Endocrine measures assessed included basal ACTH, ACTH responses to thyrotropin-releasing hormone (TRH) stimulation tests, basal insulin, insulin responses to oral sugar tests (OST), total cortisol, and free cortisol. Systemic immune function measures included basal and stimulated whole blood and peripheral blood mononuclear cell (PBMCs) cytokine and receptor expression, plasma myeloperoxidase levels, and complete blood counts. Localized immune function measures within the lung included cytokine and receptor expression after stimulation of cells obtained via bronchoalveolar lavage (BAL), myeloperoxidase levels in BAL fluid, and BAL fluid cytology. We hypothesized that PPID would affect immune function, but that any alterations would be corrected by treatment with PRASCEND. Results for the endocrine analyses showed that basal ACTH was reduced in the PRASCEND-treated horses to the levels of the Non-PPID horses, but ACTH in response to TRH stimulation was only reduced in the PRASCEND-treated horses at non-fall timepoints. PPID did not affect basal insulin, insulin responses to OSTs, total cortisol, or free cortisol, and PRASCEND treatment did not appear to have an impact on these measures either. These results suggest that PPID and hyperinsulinemia/insulin dysregulation are distinct endocrine conditions, and that the excess ACTH in horses with PPID is inactive, as it is unable to stimulate a normal cortisol response. In the immune function analyses, PPID horses had decreased expression of interferon gamma (IFNγ) from PBMCs stimulated with Rhodococcus equi and Escherichia coli and increased transforming growth factor beta (TGFβ) expression from the E. coli-stimulated PBMCs. TGFβ was also increased in PPID horses in the unstimulated whole blood samples. These results suggest that PPID horses are unable to mount an appropriate Th1 response, and that the regulatory subset of T-lymphocytes may be contributing to this decreased Th1 response. Results for the localized immune function analyses may indicate altered Th2 responses within the lung of PPID horses, although these results were severely limited by the sample size available for analyses. PRASCEND did not appear to affect immune function as measured in this study. In summary, PRASCEND successfully reduces basal ACTH in PPID horses and remains the best choice for veterinarians in monitoring dosage and response to PRASCEND treatment. Insulin, total cortisol, and free cortisol were not affected by PPID status or PRASCEND treatment in this study. Immune function was altered in horses with PPID, and it is likely that these horses are indeed at increased risk of opportunistic infection. PRASCEND treatment did not correct the differences in immune function in this study. Additional research is needed to further understand which mechanisms are driving the alterations in immune function for horses with PPID.