Diagnosing Microcystin Intoxication of Canines: Clinicopathological Indications, Pathological Characteristics, and Analytical Detection in Postmortem and Antemortem Samples
Diagnosing Microcystin Intoxication of Canines: Clinicopathological Indications, Pathological Characteristics, and Analytical Detection in Postmortem and Antemortem Samples
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DOI：
10.3390/toxins11080456
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发表时间：
2019-08-01
期刊：
影响因子：
4.2
通讯作者：
Fogelson, Susan B.
中科院分区：
文献类型：
--
作者：
Foss, Amanda J.;Aubel, Mark T.;Fogelson, Susan B.
2018年夏天，美国佛罗里达州马丁县6只暴露于微囊藻有害藻华（HAB）的狗出现了微囊藻毒素中毒的临床病理症状（即急性呕吐、腹泻、严重血小板减少、谷丙转氨酶升高、出血）。提供了成功的支持性兽医护理，并导致除一名患者外所有患者存活。通过对临床病理异常、组织病理检查、显微镜检查（呕吐物）和死前/死后样本（呕吐物、血液、尿液、胆汁、肝脏、肾脏、毛发）的分析性MC检测来确认MC中毒。死者肉眼及显微镜检查证实大量肝坏死，轻度多灶性肾小管坏死，多脏器系统出血。对呕吐物样本的显微镜检查证实存在微囊藻。采用了三种分析性MC检测方法，包括MMPB（2-甲基-3-甲氧基-4-苯基丁酸）技术、靶向同系物分析（如MC- lr的液相色谱串联质谱法）和酶联免疫吸附法（ELISA）。在死亡犬的肝脏、胆汁、肾脏、尿液和血液中均检测到总Adda MCs（作为MMPB）。一只幸存狗的尿液分析（MMPB）显示暴露后1天MCs水平较高（32,000 ng mL(-1)），暴露后2个月可检测到MCs。此外，幸存犬的毛发对MMPB呈阳性，说明了另一种可测试的犬类MC消除途径。所描述的病例是首次使用尿液作为死前，非侵入性标本诊断微囊藻毒素中毒。无论是急性还是慢性，通过死前诊断检测来确认MC中毒病例，对于提供最佳支持性护理和减轻MC暴露至关重要。
In the summer of 2018, six dogs exposed to a harmful algal bloom (HAB) of Microcystis in Martin County Florida (USA) developed clinicopathological signs of microcystin (MC) intoxication (i.e., acute vomiting, diarrhea, severe thrombocytopenia, elevated alanine aminotransferase, hemorrhage). Successful supportive veterinary care was provided and led to survival of all but one patient. Confirmation of MC intoxication was made through interpretation of clinicopathological abnormalities, pathological examination of tissues, microscopy (vomitus), and analytical MC testing of antemortem/postmortem samples (vomitus, blood, urine, bile, liver, kidney, hair). Gross and microscopic examination of the deceased patient confirmed massive hepatic necrosis, mild multifocal renal tubular necrosis, and hemorrhage within multiple organ systems. Microscopy of a vomitus sample confirmed the presence of Microcystis. Three analytical MC testing approaches were used, including the MMPB (2-methyl-3-methoxy-4-phenylbutyric acid) technique, targeted congener analysis (e.g., liquid chromatography tandem-mass spectrometry of MC-LR), and enzyme-linked immunosorbent assay (ELISA). Total Adda MCs (as MMPB) were confirmed in the liver, bile, kidney, urine, and blood of the deceased dog. Urinalysis (MMPB) of one surviving dog showed a high level of MCs (32,000 ng mL(-1)) 1-day post exposure, with MCs detectable >2 months post exposure. Furthermore, hair from a surviving dog was positive for MMPB, illustrating another testable route of MC elimination in canines. The described cases represent the first use of urine as an antemortem, non-invasive specimen to diagnose microcystin toxicosis. Antemortem diagnostic testing to confirm MC intoxication cases, whether acute or chronic, is crucial for providing optimal supportive care and mitigating MC exposure.