A review of cellular and molecular mechanisms in endocrinopathic, sepsis-related and supporting limb equine laminitis.
Authors: Elliott Jonathan, Bailey Simon R
Journal: Equine veterinary journal
Summary
# Editorial Summary: Cellular and Molecular Mechanisms in Equine Laminitis Elliott and Bailey's comprehensive 2023 review synthesises 15 years of experimental and clinical research to examine three distinct laminitis phenotypes—endocrinopathic, sepsis-related and supporting limb—with the aim of identifying shared and divergent pathological pathways at the cellular level. The authors propose that basal epithelial cell stress represents a central triggering event across all three categories, whilst acknowledging that naturally occurring pasture-associated laminitis likely involves variable contributions from multiple concurrent pathways rather than a single dominant mechanism. Their work is particularly significant for practitioners managing insulin-dysregulated horses and ponies, as it contextualises the seminal findings that hyperinsulinaemia and elevated glucose can independently induce laminar pathology and functional failure—findings that have already shifted clinical practice toward metabolic screening and dietary management. By integrating molecular data from controlled experimental models with observations from naturally occurring disease, the authors provide a framework for understanding why individual horses present with different clinical severities and progression rates, and why interventions targeting a single pathway may prove insufficient in complex, naturally occurring cases. This synthesis has direct implications for diagnostic prioritisation, prognostic counselling and treatment strategy selection across all equine disciplines and management systems.
Read the full abstract on PubMed
Practical Takeaways
- •Identify insulin dysregulation in ponies with pasture-associated laminitis, as this endocrinopathic phenotype represents a distinct disease mechanism requiring targeted management
- •Recognize that laminitis can result from multiple different pathways (metabolic, inflammatory/septic, biomechanical), and naturally occurring cases may involve contributions from several mechanisms simultaneously
- •Understanding the cellular and molecular basis of laminitis pathogenesis can inform preventive strategies and treatment approaches targeting basal epithelial cell stress
Key Findings
- •Basal epithelial cell stress is proposed as a central event common to all three categories of equine laminitis
- •Insulin dysregulation is a key mechanism in endocrinopathic laminitis, with prolonged insulin and glucose infusions experimentally inducing laminar pathology
- •Multiple molecular pathways contribute to laminar lamellar pathology in naturally occurring laminitis with varying contributions from endocrinopathic, sepsis-related, and supporting limb mechanisms
- •Interactions between different laminitis-associated pathways have been identified based on 15 years of experimental model research