AUTHOR=Bulgarelli Cecilia , Ciuffoli Elena , Troia Roberta , Goggs Robert , Dondi Francesco , Giunti Massimo 

TITLE=Apolipoprotein A1 and serum amyloid A in dogs with sepsis and septic shock

JOURNAL=Frontiers in Veterinary Science

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1098322

DOI=10.3389/fvets.2023.1098322

ISSN=2297-1769

ABSTRACT=<sec><title>Introduction</title><p>Apolipoprotein-A1 (Apo-A1) acts as a negative acute phase protein (APP) during inflammatory states, and has a potential prognostic value in people and dogs with sepsis. The aim of this retrospective study was to investigate the association of serum Apo-A1 concentration with disease severity, multiorgan dysfunction syndrome (MODS) and outcome in a population of dogs with sepsis, and to assess its correlation with major canine APPs.</p></sec><sec><title>Methods</title><p>Ninety-nine dogs with uncomplicated sepsis (<italic>n</italic> = 78) or septic shock (<italic>n</italic> = 21) were included. The serum concentration of Apo-A1, C-reactive protein (CRP) and serum amyloid A (SAA) were recorded, alongside the canine acute patient physiologic and laboratory evaluation fast (APPLE<sub>fast</sub>) score and the presence of MODS.</p></sec><sec><title>Results</title><p>Dogs with septic shock had significantly lower serum Apo-A1 concentrations (106.3 ± 22.7 mg/dl; reference interval: 123.0–142.3 mg/dl), higher APPLE<sub>fast</sub> score (30, 13–38) and greater frequency of MODS (67%) compared to those with uncomplicated sepsis (117.9 ± 19.3 mg/dl; 25, 6–33 and 8%, respectively) (<italic>P</italic> = 0.0201; <italic>P</italic> = 0.0005; P &lt; 0.0001, respectively). Similarly, dogs with MODS had significantly lower serum Apo-A1 concentrations (104.1 ± 4.6 mg/dl) and higher APPLE<sub>fast</sub> score values (31, 13–38) compared to those without MODS (118.32 ± 2.1 mg/dl and 26, 6–33, respectively) (<italic>P</italic> = 0.0050 and <italic>P</italic> = 0.0038, respectively). Conversely, neither CRP nor SAA were different between these groups. No difference in serum APPs concentrations was detected between survivors and non-survivors. Significant negative correlations were detected between serum Apo-A1 and SAA (<italic>P</italic> = 0.0056, <italic>r</italic> = −0.277), and between serum Apo-A1 and the APPLE<sub>fast</sub> score (<italic>P</italic> = 0.0027, <italic>r</italic> = −0.3). In this population, higher values of the APPLE<sub>fast</sub> score and the presence of MODS were independently associated with a higher risk of death.</p></sec><sec><title>Discussion</title><p>Our study shows that Apo-A1 is a useful biomarker of sepsis severity in dogs, since it is decreased in those with septic shock and MODS. Further prospective investigations are deemed to evaluate the applicability of Apo-A1 to predict sepsis course and response to treatment in septic dogs.</p></sec>