Introdução: A tuberculose (TB) é uma das infecções mais prevalentes na humanidade, sendo o comprometimento pulmonar a principal causa de morbimortalidade. A cultura é o padrão de referência para diagnóstico, porém apresenta baixa sensibilidade. Das formas extrapulmonares, a TB pleural é a mais comum e apresenta diagnóstico confirmatório difícil por ser paucibacilar e conter interferentes intrínsecos na amostra. A reação em cadeia da polimerase (PCR), por amplificar o DNA da micobactéria, apresenta-se como teste mais sensível que a cultura, sendo positivo em amostras que apresentam a partir de 102 UFC/mL (unidades formadoras de colônia por mL) de M. tuberculosis (MTB). Entretanto, quando utilizada em amostras de escarro, lavado broncoalveolar e/ou líquido pleural pode ter seu desempenho comprometido pela presença de inibidores intrínsecos da amostra (variáveis pré-analíticas) e pelas técnicas de amplificação e detecção (variáveis analíticas) utilizadas na reação. Objetivo: Avaliar a influência de variáveis pré-analíticas (concentração de células, hemácias e proteínas) na detecção do DNA do M. tuberculosis em amostras de escarro, lavado broncoalveolar (LBA) e líquido pleural (LP), utilizando combinações de métodos de extração/detecção. Métodos: Amostras de escarro, lavado broncoalveolar e líquido pleural de pacientes não infectados pelo M. tuberculosis foram obtidas através de indução à expectoração, broncoscopia respiratória e/ou toracocentese, respectivamente, em volumes suficientes para o estudo. Para testar o limiar de detecção do M. tuberculosis, as amostras foram preparadas \"in vitro\" de maneira a conter concentrações variadas dos interferentes pré-analíticos e de UFC/mL da micobactéria. Para a técnica de PCR, o DNA foi extraído pelo método de extração QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) e pelo AMPLICOR® Respiratory Specimen Preparation (Roche Molecular Systems, Inc., Branchburg, NJ, USA) e amplificado e detectado por três métodos: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) e 3) \"in-house\" ou caseiro. Desta maneira, foram testadas as seguintes combinações: Extração Roche/detecção Roche (R/R); Extração Roche/detecção Nanogen (R/N); Extração Roche/detecção \"in house\" (R/IH); Extração Qiagen/detecção Roche (Q/R); Extração Qiagen/detecção Nanogen (Q/N) e Extração Qiagen/detecção \"in house\" (Q/IH). Resultados: Em amostras de escarro, a quantidade de células e de hemácias não interferiu na detecção do M. tuberculosis, com exceção do método de extração/detecção Roche. Nas amostras de LBA, médias e altas concentrações de células e altas concentrações de hemácias contribuíram para menor detecção do MTB quando utilizado o método de detecção Roche, enquanto que no líquido pleural, a concentração de hemácias foi a variável que mais interferiu na detecção do agente. Em ambas as situações a menor detecção foi obtida com a combinação Q/N. Conclusão: A qualidade pré-analítica das amostras biológicas recebidas no laboratório clínico pode interferir no desempenho diagnóstico dos testes moleculares. A escolha dos métodos de extração e detecção é de fundamental importância na sensibilidade analítica do teste, para garantia de melhores resultados, especialmente quando trabalhamos com amostras paucibacilares que contém potenciais inibidores da reação / Introduction: Tuberculosis (TB) is one of the most prevalent infections in humanity, and pulmonary compromise is the leading cause of morbidity and mortality. Culture is the reference standard for diagnosis, but has low sensitivity. Of the extrapulmonary forms, pleural TB is the most common and presents difficult confirmatory diagnosis due to be paucibacillary and to contain intrinsic interfering in the sample. The polymerase chain reaction (PCR), for amplifying DNA of the mycobacterium, appears as more sensitive test than the culture, with positive results from 102 CFU/ml (colony forming units per ml) of M. tuberculosis (MTB). However, when used in sputum samples, bronchoalveolar lavage and/or pleural fluid, this test can also have its performance compromised by the presence of intrinsic sample inhibitors (pre-analytical variables) and by the amplification and detection techniques (analytical variables) used in the reaction. Objective: To evaluate the influence of pre-analytical variables (concentration of cells, red blood cells and proteins) in DNA detection of M. tuberculosis from sputum, bronchoalveolar lavage (BAL) and pleural fluid (PF) samples by using combinations of extraction/detection methods. Methods: Samples of sputum, bronchoalveolar lavage and pleural fluid of patients not infected with M. tuberculosis were obtained by inducing sputum, respiratory bronchoscopy and/or thoracentesis, respectively, in sufficient volumes for the study. To test the detection threshold of M. tuberculosis, samples were prepared \"in vitro\" to contain variable concentrations of pre-analytical interfering and CFU/mL of mycobacteria. For PCR, DNA was extracted by two methods: the QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) and Respiratory Specimen Preparation Amplicor (Roche Molecular Systems, Inc., Branchburg, NJ, USA) and amplified and detected by three methods: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) and 3) \"in-house\". Thus, the following combinations were tested: Roche extraction and detection (R/R); Roche extraction and Nanogen detection (R/N); Roche extraction and \"in house\" detection (R/IH); Qiagen extraction and Roche detection (Q/R); Qiagen extraction and Nanogen detection (Q/N) and Qiagen extraction and \"in house\" detection (Q/IH). Results: In sputum samples, the amount of cells and red blood cells did not interfere with M. tuberculosis detection, an exception for Roche extraction/detection method. In BAL samples, medium and high cell concentrations and high concentrations of red blood cells contributed to lower detection of MTB when using the Roche detection method, while in the pleural fluid, the concentration of red blood cells was the variable that most interfered with the MTB detection. In both situations, the smallest detection was obtained with the combination Q/N. Conclusion: The pre-analytical quality of biological samples received in the clinical laboratory can interfere with the performance of molecular diagnostic tests. The choice for the extraction/detection methods is of fundamental importance in the analytical sensitivity of PCR, in order to guarantee better results, especially when working with paucibacillary samples containing potential reaction inhibitors

Poor athletic performance of racehorses is a major and significant problem in the racing industry. Determining the definitive reason for poor-performance is however a real diagnostic challenge since many of the causative conditions are multifactorial and may only be manifested during exercise. A retrospective study, including various breeds of horses, confirmed musculoskeletal, cardiovascular and upper respiratory tract clinical problems to be the most frequently implicated in reducing athletic performance. Evaluation of the lower respiratory tract was though not performed in this study. The aim of the first part of this work were thus to determine the prevalence of different sub-clinical diseases in a population of poorly-performing Standardbred trotters, and to evaluate the sportive repercussions by comparing their physiological response to exercise with control horses. Fifty horses underwent thorough clinical and ancillary examinations, including haematological et biochemical evaluation, Doppler echocardiography, standardised exercise tests on treadmill et racetrack, treadmill video-endoscopy et collection of respiratory fluids. Most of the poorly-performing horses exhibited many concomitant diseases. The most frequently diagnosed sub-clinical problems involved the lower and upper respiratory tract. Poor-performers also exhibited higher values of blood lactate and heart rate, as well as lower values of haematological parameters and anti-oxidants, compared to control horses. Inflammatory airway disease being mostly present in poorly-performing horses, the second part of this work will mainly focus on this syndrome. The negative impact of inflammatory airway disease, as diagnosed by cytological evaluation of bronchoalveolar lavage fluid, has previously been described on respiratory function using either forced expiration or forced oscillations techniques. Sedation or bronchoprovocation were however usually required. On the other hand, the clinical significance of tracheal inflammation remains currently controversial. The aim was therefore to exhibit and define the respiratory dysfunctions present in horses subclinically suffering from inflammatory airway disease. Respiratory function was evaluated at rest by IOS in 34 Standardbred trotters, whereas tracheal mucus score, and both tracheal and bronchoalveolar lavages were performed 60 min post-exercise. According to the cytology of bronchoalveolar lavage fluid, the inflammatory group included 19 horses and 15 horses were used as control. A significant correlation was found between both cytological evaluations concerning neutrophil counts, whereas no association was found between tracheal mucus and any cytology. A significant increase of respiratory resistance at the lower frequencies (1 10 Hz) as well as a significant decrease of respiratory reactance beyond 5 Hz was observed in inflammatory compared to control horses. Both parameters were also significantly different between inspiration and expiration in the inflammatory group only. Both eosinophil and mast cell counts of the bronchoalveolar lavage fluid were significantly correlated with respectively respiratory resistance and reactance. The present work involved intensive clinical and functional evaluation of control and asymptomatic poorly-performing horses. The different studies allowed establishing the prevalence of medical subclinical diseases in these latter and evaluating its sportive impact considering the associated physiological responses to exercise. The presence of respiratory dysfunctions in horses with lower airway inflammation, the major trouble associated with disappointing performance, were also exhibited by impulse oscillometry./ La contre-performance est un problème majeur dans lindustrie des courses. En déterminer la cause exacte reste néanmoins un défi diagnostic puisque la plupart des affections présentes sont souvent subcliniques, multifactorielles et peuvent ne se manifester que pendant lexercice. Une étude rétrospective, incluant des chevaux de différentes races et disciplines, a ainsi confirmé les affections cliniques des voies respiratoires supérieures, musculo-squelettiques et cardiovasculaires comme étant les plus fréquemment impliquées dans la réduction des performances athlétiques. Cependant, lévaluation des voies respiratoires profondes navait pas été effectuée chez ces différents chevaux. Lobjectif de la première partie de ce travail était donc de déterminer la prévalence des différentes affections sub-cliniques induisant une contre-performance chez des Trotteurs Français, et den évaluer les répercussions sportives par la comparaison des réponses physiologiques à lexercice avec celle de chevaux contrôles. Cinquante chevaux ont respectivement été soumis à un examen clinique complet, une prise de sang pour analyse hémato-biochimique au repos et 60 minutes après chaque test deffort, une échocardiographie Doppler, des tests deffort standardisés sur piste et tapis roulant, une endoscopie à leffort, une évaluation locomotrice à grande vitesse, ainsi quun lavage trachéal et broncho-alvéolaire réalisés 60 minutes post-effort. La plupart des chevaux contre-performants ou intolérants à leffort présentaient plusieurs affections concomitantes. Les troubles sub-cliniques les plus fréquemment diagnostiqués concernaient respectivement les voies respiratoires profondes et supérieures. Ces chevaux présentaient par ailleurs des paramètres hématologiques (taux dhémoglobine et volume globulaire moyen) et anti-oxydants significativement inférieurs, et des paramètres pro-oxydants significativement supérieurs aux chevaux contrôles. De plus, les valeurs de fréquence cardiaque et lactatémie étaient, lors des différents tests deffort, significativement supérieures à celles des chevaux contrôles, Linflammation des voies respiratoires profondes étant majoritairement présente chez ces chevaux présentant des performances décevantes, la deuxième partie de ce travail se concentre plus spécifiquement sur ce syndrome. Limpact négatif sur la fonction respiratoire de cette affection, telle que diagnostiquée par lévaluation cytologique du liquide de lavage broncho-alvéolaire, a précédemment été décrite à laide de techniques dexpiration forcée ou doscillations forcées. Une sédation ou une bronchoprovocation étaient cependant généralement requises pour la réalisation de ces tests. Parallèlement, la signification clinique de linflammation trachéale reste actuellement controversée. Lobjectif était ainsi de mettre en évidence et définir les dysfonctions respiratoires présentes chez des chevaux souffrant sub-cliniquement de maladie inflammatoire des voies respiratoires. La fonction respiratoire a été évaluée au repos par oscillométrie à impulsions chez 34 Trotteurs Français asymptomatiques, alors que le score de mucus trachéal et les différents lavages ont été évalués 60 minutes post-effort. Sur base de la cytologie broncho-alvéolaire, le groupe inflammatoire comprenait 19 chevaux et 15 ont été utilisés comme contrôles. Une corrélation significative était observée entre les cytologies concernant le taux de neutrophiles, alors quaucune association nétait présente entre score de mucus trachéal et cytologies des différents lavages. Une augmentation significative de la résistance respiratoire aux faibles fréquences (1 à 10 Hz) et une diminution de la réactance respiratoire au-delà de 5Hz a été observée chez les chevaux inflammatoires comparativement aux contrôles. Ces deux paramètres étaient également significativement différents entre inspiration et expiration dans le groupe inflammatoire uniquement. La résistance et la réactance respiratoire étaient par ailleurs respectivement corrélées aux taux déosinophiles et de mastocytes du lavage broncho-alvéolaire. Ce travail comprenait une évaluation clinique et fonctionnelle intensive chez des chevaux contrôles et des chevaux contre-performants. Les études menées ont permis détablir la prévalence des affections médicales sub-cliniques chez ces derniers et den évaluer limpact sportif par lintermédiaire des réponses physiologiques à lexercice. La présence de dysfonctions respiratoires chez les chevaux avec inflammation des voies respiratoires profondes, premier trouble associé à des performances décevantes, a également pu être mise en évidence à laide de loscillométrie à impulsion.

One-lung ventilation (OLV) as an established procedure during thoracic surgery may be injurious in terms of increased mechanical stress characterised by alveolar cell stretch and overdistension, increased cyclic tidal recruitment of alveolar units, compression of alveolar vessels and increased pulmonary vascular resistance. This may result in ventilation-induced lung injury with pro-inflammatory cytokine production, leukocyte recruitment and neutrophil-dependent tissue destruction. Despite the consequences of delivering the whole tidal volume (VT) to only a single lung, relatively high VT are used during OLV to maintain arterial oxygenation and carbon dioxide elimination. However, this may increase mechanical stress in the dependent lung and may aggravate alveolar injury. There is a lack of data on the alveolar immune consequences of OLV. Therefore, the present studies investigate the epithelial damage and pro-inflammatory response induced by mechanical ventilation and OLV. OLV induced pulmonary injury, but alveolar damage in the ventilated lung decreased by reduction of the tidal volume in patients scheduled for thoracic surgery (study I). The use of the volatile anaesthetic desflurane in OLV patients attenuated the OLV-induced alveolar immune response (study II). Furthermore, an experimental model of thoracic surgery was established to investigate the systemic and pulmonary consequences of OLV and thoracic surgery in comparison with the effects of conventional two-lung ventilation and spontaneous breathing. The experimental data indicate that beside the pulmonary immune response volatile anaesthetics have also modulated the plasma concentrations of cytokines during and after OLV (study III). In contrast, OLV and thoracic surgery increased the expression of pro-inflammatory mRNA in BAL cells and lung tissue samples. General anaesthesia did not affect this response (study 4). The results of the present studies indicate that OLV and thoracic surgery may be injurious to the lung tissue to a similar degree. The recruitment and activation of alveolar granulocytes characterise the alveolar damage. The administration of different anaesthetics modulates the activation of alveolar cells, specified by decreased inflammatory mediator release in subjects that receive desflurane anaesthesia, which does not affect the expression of cytokine mRNA in alveolar cells and lung tissue samples.

This study investigated proteomic changes in bronchoalveolar lavage fluid (BALF) of beef calves to identify alterations related to development of naturally occurring bovine respiratory disease. BALF was collected from 162 healthy beef calves soon after weaning and transportation. Two-dimensional gel electrophoresis and mass spectrometric analysis revealed calves that later developed pneumonia had significantly lower levels of anti-inflammatory proteins including annexin A1, RAGE-binding protein, apolipoprotein-A, heat shock protein beta-1 and thioredoxin, but higher levels of antioxidant and pro-inflammatory proteins such as immunoglobulin light chain variable region, cyclophilin A, serum albumin precursor and glutathione S-transferase P. Difference in gel electrophoresis-based analysis further showed lower levels of annexin A1, annexin A2, peroxiredoxin I, calycyphosin, superoxide dismutase, macrophage capping protein and dihydrodiol dehydrogenase 3 in the calves that later developed pneumonia. Differences in annexin levels were partially confirmed by Western blot analysis. In healthy calves, immunohistochemistry revealed cytoplasmic expression of annexin A1 in surface epithelium of large airways, tracheobronchial submucosal glands, and goblet cells, and to a lesser degree in small airways but not in alveolar epithelium. Flow cytometry and immunocytochemistry labeled annexin A1 in blood and bronchoalveolar lavage neutrophils, monocytes, macrophages and lymphocytes. Annexin A2 expression was detected in surface epithelium of small airways, some mucosal lymphocytes, and endothelium, with weak expression in large airways, tracheobronchial submucosal glands and alveolar epithelium. For both proteins, the level of expression was similar in tissues collected 5 days after intrabronchial challenge with M. haemolytica compared to that from sham-inoculated calves. A sandwich ELISA for annexin A1 was developed. For use with BALF, the working range was 0.3-317 ng/ml and the sensitivity was 0.8 ng/ml. The coefficient of variation of intra-assay and the between assays was less than 20%. Together, these findings reveal annexins A1 and A2 as promising biomarkers of susceptibility to BRD in healthy at-risk calves. Further, the anti-inflammatory and pro-resolving functions of these proteins suggest roles in the pathogenesis of bacterial pneumonia of feedlot cattle. / Natural Sciences and Engineering Council (NSERC), Ontario Cattlemen’s Association, Ontario Ministry of Agriculture and Food and Ontario Veterinary College Fellowship Program

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The definitive diagnosis of strongyloidiasis is normally done by detection of larvae on faecal samples; however, the number of parasites is limited in most cases and the elimination of larvae is irregular. Thus, developing reliable serological methods for the diagnosis of strongyloidiasis becomes imperative. The aim of this study was to establish a coproantigen ,antigen, antibody and immune complex detection by enzyme-linked immunosorbent assay in serum and bronchoalveolar lavage fluid (BALF) samples of non immunosuppressed or immunosuppressed rats experimentally infected with Strongyloides venezuelensis. For kinetics of coproantigen detection (0 and 5, 8, 13 and 21 days post-infection (d.p.i)), we used an anti-L3 polyclonal antibody produced in rabbits. For antigen and immune complex detection in serum and BALF samples (0 and 2, 5, 8, 13 and 21d.p.i), the microtitre plates were coated with IgG anti-S. venezuelensis and with alkaline parasite extract for antibody detection. The statistical analysis were analyzed using Two Way ANOVA, followed by the Bonferroni test. The criterion for statistical significance was set at p<0,05. The number of eggs/g of faeces recovered at 8 d.p.i was significantly higher for non immunosuppressed and immunosuppressed animals (p<0.01). The coproantigen detection was significantly higher at 13° d.p.i in non immunosuppressed (p<0.05) and in immunosuppressed it was anticipated to the 5th d.p.i. It was observed that antigen detection in serum samples was not a good approache for evaluating the infection however in BALF samples it showed superior results. In immunosuppressed animals, IgG specific for S. venezuelensis was preferentially detected during the 5° and 13° d.p.i and in immunosuppressed animals, during the entire experimental kinetics. In BALF samples, antibodies detection was observed from the 8° to the 21° d.p.i in non immunosuppressed animals and in immunosuppressed animals it was anticipatedto the 2° d.p.i, with higher reactivity at 5° d.p.i (p<0.05). The immune complex detection in serum samples of the non immunosuppressed animals was observed from the 5° to the 13° d.p.i and in immunosuppressed animals, during the entire kinetics. In BALF samples, immune complex detection was higher in non immunosuppressed animals. In conclusion, coproantigen and immune complex detection in serum and BALF samples are alternatives for early strongyloidiasis diagnosis, mainly in immunocompromised cases. / O diagnóstico definitivo da estrongiloidíase normalmente é realizado mediante a detecção de larvas nas fezes; porém a quantidade de parasitos é limitada e a eliminação de larvas é reduzida e irregular. Sendo assim, o desenvolvimento de testes sorológicos confiáveis para o diagnóstico da estrongiloidíase torna-se uma alternativa necessária. O objetivo deste estudo foi demonstrar a cinética de detecção de coproantígenos e de antígenos, anticorpos e imunocomplexos circulantes em amostras de soro e de lavado bronco alveolar (LBA) de ratos imunossuprimidos e experimentalmente infectados por Strongyloides venezuelensis. Para a cinética (0 e 5, 8, 13 e 21 dias pós-infecção (d.p.i)) de coproantígenos utilizou-se anticorpo policlonal anti-L3 produzido em coelhos. Para a detecção de antígenos e de imunocomplexos em amostras de soro e de LBA (0 e 2, 5, 8, 13 e 21 d.p.i), placas de microtitulação foram sensibilizadas com IgG anti-S. venezuelensis e com extrato alcalino de larvas para a detecção de anticorpos. A análise estatística foi realizada por Two Way ANOVA, seguida pela teste de Bonferroni, considerando p<0,05 significativo. A cinética de eliminação de ovos/g de fezes mostrou que o pico ocorre no 8° d.p.i sendo significativamente maior nos animais imunossuprimidos (p<0,01). O pico de detecção de coproantígenos nos animais não imunossuprimidos foi no 13° d.p.i (p<0,05), sendo que nos animais imunossuprimidos a detecção foi antecipada para o 5° d.p.i. A detecção de antígeno em amostras de soro não foi uma boa ferramenta diagnóstica para avaliar a infecção enquanto que em amostras de LBA mostrou ser ferramenta auxiliar. A detecção de IgG específica para S. venezuelensis em amostras de soro de animais não imunossuprimidos foi preferencialmente durante o 5° e o 8° d.p.i. e em animais imunossuprimidos, durante toda a cinética experimental. Nas amostras de LBA, a detecção de anticorpos ocorreu do 8° ao 21° d.p.i em animais não imunossuprimidos e em animais imunossuprimidos, foi antecipada para o 2° d.p.i, como pico de reatividade no 5° d.p.i (p<0,05). A detecção de imunocomplexos em amostras de soro de animais não imunossuprimidos foi possível do 5° aos 13° d.p.i e em animais imunossuprimidos, durante toda a cinética. Em amostras de LBA, a detecção de imunocomplexo foi maior em animais não imunossuprimidos. Concluiu-se que a detecção de coproantígeno e de imunocomplexos circulantes em amostra de soro e em amostras de LBA são uma alternativa para o diagnóstico precoce da estrongiloidíase principalmente nos casos de imunossupressão. / Doutor em Imunologia e Parasitologia Aplicadas

Estudamos o efeito do tratamento com salbutamol em dois regimes: diário (DS) e administrado a intervalos de 96 horas (IS) em camundongos balb/c sensibilizados com injeções intraperitoneais de uma solução de ovoalbumina (OVA) adsorvida em hidróxido de alumínio, e desafiada com inalações de ovoalbumina a 1%. O grupo controle SAL recebeu injeções i.p. de salina e desafios inalatórios de sallina. A partir do 34o dia, os animais OVA foram tratados com salbutamol via inalatória 10 mg/ml durante 15 minutos nos dois regimes descritos. Os animais foram sacrificados no 60o dia, que corresponde a 48 horas após o último desafio antigênico. Após os camundongos serem anestesiados com pentobarbital sódico via i.p., eles foram traqueostomizados e entubados e sacrificados com secção da Aorta abdominal. Então, procedeu-se com a coleta do lavado broncoalveolar para a quantificação de leucócitos. Coletamos os tecidos pulmonares para a avaliação do processo inflamatório por quantificação de células linfomononucleares (LMN) e eosinófilos EPO+, essa última com marcação citoquímica. Além disso, estudamos a influência do tratamento adrenérgico sobre o IgE anafilático. O modelo de inflamação (grupo OVA) produziu significativo aumento do número de células totais, de eosinófilos e de neutrófilos observados na avaliação de lavado broncoalveolar. Além disso, houve nesse grupo processo inflamatório na parede de vias aéreas, caracterizada por um infiltrado linfomononuclear e com presença de eosinófilos. O nosso processo de indução de inflamação também recrutou eosinófilos para o septo alveolar. O tratamento com salbutamol diário produziu uma queda significativa do processo inflamatório no BAL, principalmente de neutrófilos e eosinófilos, enquanto que o tratamento intermitente produziu redução significativa apenas de neutrófilos. O tratamento com salbutamol a cada 96 horas (IS) promoveu uma queda significativa de células LMN quantificadas no septo alveolar, mas não atingindo valores do grupo salina (NS). Ambos os tratamentos com salbutamol produziu redução significativa de células EPO+ no parênquima pulmonar (P < 0,05). Apesar das alterações no processo celular, o salbutamol não influenciou na expressão de anticorpos IgE anafiláticos a OVA. Assim, podemos concluir que o salbutamol apresenta atividade imunomoduladora, observada por redução de eosinófilos no BAL e no parênquima pulmonar, apesar de não atingir valores semelhantes aos animais do grupo salina / We studied the effects of salbutamol treatment in two regimen: diary (DS) and at interval of 96 hours (IS) in ovalbumin sensitized (OVA) balb/c mice. The control group (NS) received i.p. injections and aerosol challenge with normal saline. Starting at day 34 the OVA animals were treated with 10mg/ml salbutamol by inhalation during 15 minutes per day in both regimen: DS and IS. The mice were sacrificed at day 60 that corresponded the fourthly eight hours after last OVA and/or salbutamol exposure. At experimental day, mice were anesthetized with i.p. injection of sodium pentobarbital, tracheostomized, entubed and the abdominal aorta sectioned. We followed with collecting of bronchoalveolar lavage (BAL) and lungs to histopathology studies. In the BAL, total cells and differential leukocytes were quantified, while in the lung sections, the EPO+ and LMN in airways wall and parenchyma septa were evaluated. Also, we sampled the blood to evaluate the effects of salbutamol on anaphylactic IgE antibodies expression. The inflammatory model (OVA animals) produced a significant increase of BAL total cells, BAL eosinophils and neutrophils, and LMN cells and EPO+ eosinophils in the airways and in the parenchyma. Diary salbutamol treatment decrease significantly BAL eosinophils and neutrophils, while the IS group showed a diminution of BAL neutrophils and LMN cells in the alveolar septum. Both salbutamol treatments produced significant decline of EPO+ cells in the lung parenchyma. Despite the changes in the cellular patterns, the salbutamol did not affect the IgE antibodies expression. So, we can concluded that salbutamol present an immunomodulatory activity observed by reduction of eosinophils in the BAL and lung parenchyma, but did not achieve the values of saline control group

Dans ce travail de thèse, l'efficacité de la voie intrapulmonaire et les paramètres biopharmaceutiques influençant la diffusion pulmonaire après nébulisation d'antibiotiques ont été évalués. La présence et l'impact de certaines pompes d'efflux dans un modèle in vitro de cellules primaires épithéliales pulmonaires de rat ont été testés. Trois fluoroquinolones et la colistine ont été utilisées comme molécules de référence. La combinaison des molécules testées a permis d'obtenir une vue d'ensemble des caractéristiques de diffusion intrapulmonaire des antibiotiques. L'étude in vivo avec les fluoroquinolones a démontré que les concentrations pulmonaires de ces molécules sont plus importantes que dans le plasma, probablement dû à la présence des transporteurs comme la glycoprotéine-P. La présence de ces transporteurs a été confirmée dans le modèle de cellules pulmonaires de rats. L'étude in vivo avec la colistine a montré qu'une lente diffusion pourrait conférer un avantage à la nébulisation par rapport à l'administration intraveineuse. En conclusion, l'administration par nébulisation des molécules, qui traversent les tissus lentement (colistine), pourrait être avantageuse, alors que pour d'autres, qui traversent vite la barrière (fluoroquinolones), la voie nébulisée pourrait ne pas présenter des avantages par rapport à la voie intraveineuse. De plus, les résultats ont démontré qu'une faible perméabilité à travers le poumon (colistine) pourrait donner un avantage à la nébulisation des antibiotiques, tandis qu'une affinité pour des transporteurs (fluoroquinolones) semble présenter un intérêt aussi bien dans le cadre d'une nébulisation que d'une administration intraveineuse. / The aim of this study was to investigate the efficiency of intrapulmonary administration and the biopharmaceutical parameters regulating the pulmonary diffusion following nebulization. We examined whether certain efflux pumps were present in an in vitro model of rat lung cells and whether these efflux pumps could be beneficial by increasing lung concentrations in vivo. Fluoroquinolones and colistin were the molecules used as reference. These different molecules allowed an overview of the intrapulmonary diffusion characteristics of antibiotics. The in vivo study with fluoroquinolones showed that their lung concentrations are higher than in plasma, probably due to glycoprotein-P. The presence of this efflux pump was confirmed in the model with rat lung cells. The in vivo study with colistin showed that a slow diffusion may confer an advantage for nebulization over intravenous administration. In conclusion, the nebulization molecules passing slowly (colistin) across the tissues may be advantageous, whereas for others, with a fast passage across the barrier (fluoroquinolones), the pulmonary route may not provide an advantage over the intravenous administration. Moreover, the results showed that a slow permeability across the lung (colistin) may confer an advantage for the antibiotic nebulization, while affinity by transporters (fluoroquinolones) is beneficial for both nebulization and intravenous administration.

Background – Feeding horses round bale hay (RBH) has been associated with airway inflammation. The purpose of this study was to determine if horses fed RBH for a 6-week period demonstrated more evidence of airway inflammation than horses fed square bale hay (SBH) of comparable quality. Hypothesis - The respiratory health of horses fed RBH will not differ from horses fed SBH of comparable quality. Animals – Two feeding groups of 15 healthy horses (mixed ages, breeds) from the University riding program. Methods – This was a prospective study performed during fall of 2009. At the beginning and end of a 6- week feeding trial, horses were examined (physical, upper airway endoscopic) and samples (tracheal aspirate (TA), bronchoalveolar lavage (BAL)) collected for cytology and/or bacterial/fungal culture. Hay was analyzed for nutritional value and bacterial/fungal content. Results – Horses fed RBH demonstrated an increase in pharyngeal lymphoid hyperplasia (p=0.0143) and percentage neutrophils (p=0.0078) in the TA samples post-feeding as compared to pre-feeding values. Nutritional analysis of hay and measurements of bacterial/fungal load did not differ over time and/or between hay types. Conclusions and clinical importance – The identification of airway inflammation in the horses fed RBH indicates that factors associated with the manner in which the hay is fed and consumed contribute to the development of subclinical airway inflammation. RBH affords horses continuous daily exposure to hay and as horses bury their muzzles in the bale, exposure to particulate matter is likely increased. These factors may partially explain the response in horses fed RBH. Further studies are required to confirm these predictions. / Master of Science

Objective - evaluate horses with acute airway obstruction using three treatment regimens: tapering doses of dexamethasone (DEX), environmental modification (ENV), and a combination of both treatments (DEX + ENV) by analyzing clinical parameters, pulmonary function testing, bronchoalveolar lavage fluid (BALF) cytology and BALF cell expression of the cytokines IFN-? and IL-4 Animals - 6 horses with recurrent airway obstruction (RAO) Procedures - Clinical examination, pulmonary function test, and collection of BALF prior to treatment and during 22 day treatment period Hypothesis - Alterations in clinical parameters, pulmonary function and airway inflammation in acute equine RAO will return to remission values by treating with DEX, ENV or DEX + ENV Results - All horses demonstrated clinical disease, reduced pulmonary dynamic compliance (Cdyn) and an increased maximum change in pleural pressures (?Pplmax) when in a challenge environment. All treatments improved clinical parameters, ?Pplmax and Cdyn. BALF cytology during an RAO crisis demonstrated neutrophilic inflammation. ENV or DEX + ENV resulted in a significant decrease in airway neutrophilia that was maintained throughout the treatment period. In contrast, treatment with DEX caused a reduction in airway neutrophilia initially followed by a rebound neutrophilia as the period between administrations of dexamethasone (0.05mg/kg) was increased to 72 hours. The rebound neutrophilia was not accompanied by equivalent deterioration in clinical parameters or pulmonary function. Conclusions - Environmental modification is important in the management of RAO horses. Treatment of clinical RAO with a decreasing dosage protocol of corticosteroids in the absence of environmental modification results in the persistence of airway inflammation without recrudescence of clinical disease. / Master of Science

Indiana University-Purdue University Indianapolis (IUPUI)