Plasma alpha-fetoprotein in neonatal foals affected by prematurity, sepsis and neonatal encephalopathy.
Authors: Lanci A, Ellero N, Castagnetti C, Perina F, Dondi F, Mariella J
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Plasma alpha-fetoprotein (AFP) has potential as a biomarker in sick neonatal foals, yet its specificity for individual conditions remains questionable. Lanci and colleagues measured AFP concentrations in 46 foals under 72 hours old presenting with prematurity (n=7), sepsis with positive blood culture and systemic inflammatory response (n=14), or neonatal encephalopathy from hypoxic-ischaemic injury (n=25), comparing results against historical healthy controls (n=20). All three disease groups demonstrated significantly elevated AFP compared to healthy foals (P<0.001), but AFP values could not differentiate between the three conditions or predict outcome; additionally, AFP showed inverse correlations with foal age (r=−0.6), bodyweight (r=−0.3), monocyte count (r=−0.4) and serum amyloid A (r=−0.4). These findings indicate AFP functions as a non-specific indicator of neonatal ill-health rather than a diagnostic tool for distinguishing sepsis, prematurity or encephalopathy, meaning clinicians should interpret elevated AFP within the broader clinical context and alongside other haematochemical markers rather than relying on it to confirm a specific diagnosis in compromised foals.
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Practical Takeaways
- •Elevated AFP in sick neonatal foals indicates systemic illness but cannot be used alone to diagnose specific conditions like sepsis versus encephalopathy
- •AFP levels naturally decline with foal age, so interpretation must account for time of sampling; measurements at <72 hours are most relevant
- •AFP may be useful as part of a broader diagnostic panel for assessing neonatal foal health status, but clinicians should rely on blood culture, SIRS criteria, and clinical signs for disease-specific diagnosis
Key Findings
- •Plasma AFP was significantly elevated in premature, septic, and neonatally encephalopathic foals compared to healthy controls (P<0.001)
- •AFP could not discriminate between different neonatal diseases or predict outcomes
- •AFP showed strong negative correlation with foal age (r=-0.6; P<0.001) and moderate negative correlation with monocyte count and serum amyloid A
- •AFP appears to be a non-specific indicator of neonatal health status, upregulating in response to multiple pathological processes including SIRS, bacteremia, prematurity, and hypoxic-ischemic injury