Evaluation of Serum Apolipoprotein A1 in Canine Sepsis

Massimo Giunti

Giorgio Grossi

Roberta Troía

Federico Fracassi

Francesco Dondi

Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy

Edited by: Micaela Sgorbini, University of Pisa, Italy

Reviewed by: Francesca Bonelli, University of Pisa, Italy; Saverio Paltrinieri, University of Milan, Italy

*Correspondence: Massimo Giunti ti.obinu@itnuig.omissam

This article was submitted to Veterinary Experimental and Diagnostic Pathology, a section of the journal Frontiers in Veterinary Science

Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy

Edited by: Micaela Sgorbini, University of Pisa, Italy

Reviewed by: Francesca Bonelli, University of Pisa, Italy; Saverio Paltrinieri, University of Milan, Italy

Received 2020 Feb 7; Accepted 2020 Apr 20.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

Decreased serum apolipoprotein A1 (Apo-A1) concentration is associated with mortality in human sepsis. The diagnostic and prognostic role of serum Apo-A1 concentrations in canine sepsis was evaluated. Serum samples from septic dogs (n = 91) and healthy controls (n = 15) were retrospectively analyzed. According to the sepsis origin, four categories were identified: parvoviral enteritis (n = 26), pyometra (n = 20), septic peritonitis (n = 19), and miscellanea (n = 26). The canine acute patient physiologic and laboratory evaluation fast score (APPLE_fast), serum C-reactive protein (CRP) and albumin concentrations were reviewed in all enrolled dogs. Increased CRP (252.6 ± 119.2 mg/L; Reference Interval: 0–8.5 mg/L) and significant lower serum albumin and Apo-A1 concentrations were documented in dogs with sepsis (22.8 ± 5.3 g/L and 1.17 ± 0.27 g/L, respectively) compared to healthy ones (33.1 ± 2.5 g/L and 1.32 ± 0.05 g/L, respectively) (P < 0.0001). According to the origin of sepsis, only the subgroup of dogs with septic peritonitis had significantly lower Apo-A1 (1.03 ± 0.26 g/L) concentrations compared to healthy dogs (P < 0.001). No significant differences were found in serum albumin and CRP concentrations, and in APPLE_fast score values among the different subgroups of sepsis. Diagnosis of septic peritonitis was associated with a higher frequency of death (P = 0.006). In septic dogs, significant lower Apo-A1 concentrations were detected in non-survivors (1.02 ± 0.28 g/L; n = 27) compared to survivors (1.23 ± 0.24 g/L; n = 64; P = 0.0007). Moreover, significant higher values of the APPLE_fast score were calculated in non-survivors (26 ± 4; n = 19) compared to survivors (23 ± 4; n = 51) (P = 0.0114). According to the area under the ROC curve analysis, Apo-A1 <96 mg/dl had a fair accuracy (AUC = 0.72) to correctly predict mortality (P = 0.0004). Apo-A1 might support a diagnosis of canine septic peritonitis with a potential prognostic significance. Further prospective studies are warranted.

Keywords: high-density lipoproteins, acute phase response, dogs, prognosis, septic peritonitis

Glossary

Abbreviations

Apo-A1	apolipoprotein A1
APPLE_fast	acute patient physiologic and laboratory evaluation fast score
CRP	C-reactive protein
HDL	high density lipoprotein
LPS	lipopolysaccharide
ROC	receiver operating characteristic
SAA	serum amyloid A
SIRS	systemic inflammatory response syndrome.

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