Use of matrix metalloproteinases 2 and 9 and white blood cell counts in monitoring the treatment and predicting the survival of horses with septic arthritis.
Authors: Kidd J A, Barr A R S, Tarlton J F
Journal: The Veterinary record
Summary
# Editorial Summary Kidd, Barr and Tarlton (2007) investigated whether synovial fluid biomarkers could improve prognostic assessment in equine septic arthritis by measuring white blood cell counts and matrix metalloproteinase (MMP) activity in synovial samples from 32 horses with suspected septic arthritis and 39 control horses euthanased for unrelated reasons. Using gelatin zymography and image analysis, they quantified both pro- and active forms of MMP2 and MMP9 in each sample, establishing baseline biochemical profiles against which clinical outcomes could be assessed. The ratio of proMMP9 to proMMP2, alongside white blood cell counts, emerged as reliable prognostic indicators of survival; notably, horses presenting early after suspected joint infection showed no significant difference in these biomarkers or survival outcomes compared to those with delayed presentation, suggesting that time to referral did not materially alter prognosis. For practitioners managing septic arthritis cases, these findings indicate that synovial fluid analysis extending beyond conventional cell counts to include MMP profiling could provide objective, quantifiable prognostic information to guide clinical decision-making and client counselling, particularly in early cases where treatment decisions are most critical.
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Practical Takeaways
- •Measure synovial fluid proMMP9:proMMP2 ratio and WBCC early in septic arthritis cases to help predict prognosis and guide treatment intensity
- •Do not use delay to treatment as a negative prognostic factor—horses referred late still have reasonable survival prospects if treated
- •Gelatin zymography analysis of joint fluid biomarkers may help stratify risk and inform owner discussions about treatment feasibility
Key Findings
- •The ratio of proMMP9:proMMP2 was a good prognostic indicator of survival in horses with septic arthritis
- •White blood cell counts (WBCC) at initial presentation were good prognostic indicators of survival
- •No significant relationship found between interval from injury to treatment referral and initial WBCC or MMP2/MMP9 levels
- •Time to referral did not significantly affect survival chances in septic arthritis cases