Current research and theories on the pathogenesis of acute laminitis in the horse.
Authors: Bailey Simon R, Marr Celia M, Elliott Jonathan
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary: Current Understanding of Acute Laminitis Pathogenesis Bailey, Marr and Elliott's 2004 review synthesises the expanding body of research into acute laminitis mechanisms, moving beyond singular causative theories to explore how inflammation, haemodynamic compromise, and enzymatic activation within the hoof tissue interact to drive disease progression. Rather than advocating for one dominant model, the authors demonstrate that competing hypotheses—including those addressing hindgut dysfunction, vascular dysfunction, and metalloproteinase activation—are largely complementary rather than contradictory, with both in vitro and in vivo experimental evidence supporting roles for each mechanism. This integrative approach explains previously puzzling clinical observations, such as the apparent lag between systemic insult and lamellar failure, and the variable clinical presentation across different triggering conditions. For practitioners, the implication is that effective prevention and treatment strategies may need to target multiple pathways simultaneously rather than rely on single interventions, and that understanding the sequence of events—from hindgut to systemic inflammation to local tissue compromise—provides a rational framework for therapeutic timing and selection. Subsequent developments in laminitis research continue to build on these mechanistic foundations, making this review essential contextual reading for anyone seeking to apply evidence-based approaches to this economically significant condition.
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Practical Takeaways
- •Acute laminitis involves interconnected mechanisms (inflammation, circulatory changes, enzyme activity) rather than a single cause—treatment strategies should address multiple pathways
- •Understanding hindgut dysfunction as a precursor to laminitis may enable earlier intervention and prevention in at-risk horses
- •Emerging research on hoof tissue enzyme activation and inflammatory cascades may eventually enable more targeted and effective therapies beyond current supportive management
Key Findings
- •Current pathogenic theories of acute laminitis are largely complementary rather than mutually exclusive, integrating multiple mechanisms
- •In vitro and in vivo disease models have clarified the roles of inflammation, haemodynamic disturbances, and enzyme activation in hoof tissue damage
- •Hindgut events preceding laminitis development represent a critical area of investigation that may explain clinical observations
- •Multiple pathogenic mechanisms must be considered simultaneously to understand acute laminitis development and inform future therapeutic strategies