Abstract
Background: Canine Leishmaniasis (CanL) is a multisystemic and chronic inflammatory disease characterized by nonspecific clinical manifestations. In CanL, inflammatory cells and chemical mediators released in response to the parasite play a role in disease development and progression. Alterations on hematological parameters have been documented in CanL. These changes can also be assessed in relation to systemic inflammation caused by this disease. The circulating leukocyte counting, such as neutrophils, as well as the albumin level, are considered direct indicators of an inflammatory host environment. Several studies point to the use of biomarkers on the assistance in diagnosis and prognosis of several canine pathologies. The present study investigated the Neutrophils to Lymphocyte Ratio (NLR), Albumin to Globulin Ratio (AGR), and Neutrophils to Albumin Ratio (NAR) on systemic inflammatory response induced by Canine Leishmaniasis (CanL).Materials, Methods & Results: For this purpose, adult dogs with confirmed diagnosis to CanL were divided into symptomatic (SD, n = 33) and asymptomatic (AD, n = 20) dogs for L. infantum and control dogs (CD, n = 20). Routine hematological and biochemical parameters were determined in blood samples using a veterinary automatic hematology and biochemical analyzers. Asymptomatic dogs (AD) had a higher number of white blood cells and neutrophils (16.48 ± 4.93; 13.41 ± 3.60, respectively) in relation to symptomatic dogs (SD) (13.54 ± 5.13; 10.42± 3.69, respectively) (P = 0.015 and P < 0.0001, respectively). Neutrophils to Lymphocyte Ratio (NLR) was higher in dogs with leishmaniasis (9.45 ± 3.76) than in healthy dogs (3.39 ± 1.19) (P < 0.0001). Serum total proteins (STP) and globulins increased in CanL, while albumin and AGR decreased in CanL, when compared to CD and references values to canine species. Neutrophils to Albumin Ratio (NAR) was higher in AD and SD (5.02 ± 1.14; 4.79 ± 1.07, respectively) when compared to CD (2.36 ± 0.55) (P < 0.0001). Discussion: As reported in scientific researches, dogs with Leishmaniasis present alterations in circulating cell counts. Based on these data, we decided to expand this information using the NLR as a parameter in an attempt to better clarify the changes in these cells in CanL. We observed that NLR was increased on CanL in relation to healthy dogs, which could be a consequence of relative neutrophilia rather than lymphopenia. Neutrophils to Lymphocyte Ratio (NLR) is a biomarker that conveys information about inflammatory conditions. An elevated NLR can reflect an upregulated innate immune response, since neutrophils are effector cells of innate immunity and are involved in several acute and chronic inflammatory processes. Albumin is an acute phase protein that is considered an immune-inflammatory biomarker, which can be found reduced systemically in progressive inflammatory response. Serum total proteins (STP) and globulins were increased in CanL. These data are already well documented in CanL, which serum globulins are mainly associated with the increase of acute phase proteins, cytokines, and increase of specific antibodies to Leishmaniainfantum. Our results showed neutrophilia with hypoalbuminemia in CanL. So, in an attempt to assess the relationship of these two available markers, we used NAR calculation in order to evaluate the changes induced by CanL. In this study NAR was higher in CanL when compared to control dogs. Thus, our data indicate that NLR and NAR could be used as biomarkers in veterinary medical clinics in order to assess inflammatory profile in CanL, mainly in asymptomatic dogs. These parameters obtained from routine blood tests might be useful as cost-effective, easily accessible and helpful markers in order to distinguish the inflammatory response intensity in CanL.
Highlights
Canine Leishmaniasis (CanL) is a multisystemic disease with a zoonotic character caused by the protozoan Leishmania infantum from the blood meal of infected sandflies [1]. which is characterized by presenting various nonspecific clinical manifestations [21,45,46]
The results indicated a tendency to neutrophilia with lymphopenia in dogs infected by L. infantum when compared to control dogs
Neutrophils to Lymphocyte Ratio (NLR) was higher in dogs with leishmaniasis (9.45 ± 3.76) than healthy dogs (3.39 ± 1.19) [P < 0.0001], and it was noted an increase in NLR of Asymptomatic dogs (AD) (11.10 ± 4.36) when compared to symptomatic dogs (SD) (8.46 ± 3.00) (P < 0.0001) [Table 1 and Figure 1]
Summary
Canine Leishmaniasis (CanL) is a multisystemic disease with a zoonotic character caused by the protozoan Leishmania infantum from the blood meal of infected sandflies [1]. which is characterized by presenting various nonspecific clinical manifestations [21,45,46].In CanL, the immune response, which is mediated by the inflammatory cells and chemical molecules induced by parasites, plays a role in development and progression of this disease [5,27,38]. The use of biomarkers, such as the albumin / globulin ratio (AGR) and the neutrophil / lymphocyte ratio (NLR), proved to be useful in the prognosis of sarcoma [24], mast cell tumor [25], multicentric lymphoma [28], septic peritonitis [17] and other inflammatory conditions in dogs [34] Another important marker to be evaluated is the Neutrophil to Albumin Ratio (NAR), since the count of circulating leukocytes, such as neutrophils, as well as the albumin level, are considered direct indicators of inflammatory host environment [13,16,20,23,44]. Our data indicate that NLR and NAR could be used as biomarkers in veterinary medical clinics in order to assess inflammatory profile in CanL, mainly in asymptomatic dogs These parameters obtained from routine blood tests might be useful as cost-effective, accessible and helpful markers in order to distinguish the inflammatory response intensity in CanL
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