title: Changes in nasal mucosal innervation in horses with grass sickness.
abstract: BACKGROUND
  Equine grass sickness is a dysautonomia characterised by widespread destruction of autonomic ganglia, resulting in the clinical signs of dysphagia, constipation, profuse sweating, tachycardia, rhinitis sicca and high mortality rate. Rhinitis sicca is a common finding in horses with the chronic form and we have postulated that alterations in autonomic innervation of the nasal mucosa might underlie this clinical presentation.
  
  
  OBJECTIVE
  In this study, the expression and distribution of nerve fibres immunoreactive for calcitonin gene-related peptide (CGRP), substance P (SP), the general neuronal marker protein gene-product 9.5 (PGP 9.5; ubiquitin) and the intermediate neurofilaments (PAN-N; neurorfilaments L, M and H) in the nasal mucosa of normal horses (n = 10) and horses with EGS (n = 18; acute n = 8, subacute n = 3, chronic n = 7) was assessed.
  
  
  METHODS
  Innervation density and distribution was investigated in the different groups using standard immunohistochemical techniques.
  
  
  RESULTS
  Significant differences were noted when comparing the density and distribution of nerve fibres immunoreactive for PGP 95 and PAN-N, with PGP 95 consistently giving better staining in all groups and at all sites in the nasal mucosa. An apparent increase in the density of innervation was noted for acute vs. normal cases. A significant reduction in the density of innervation was noted only with PAN-N when comparing normal horses and acute cases with the chronic group (P < 0.05). CGRP and SP immunoreactive nerve fibres were typically most abundant in the epithelial and subepithelial layers, but the quality of staining and nerve fibre density was greater for SP, achieving significant difference in several comparisons. The density of innervation for SP was significantly reduced in the chronic group compared to the normal and acute groups (P < 0.01). A significant decrease was noted for CGRP only for the acute and chronic groups (P<0.05).
  
  
  CONCLUSIONS
  These results demonstrate a reduction in the expression of the sensory neuropeptides in nasal mucosal innervation as a consequence of equine dysautonomia, and may underlie the clinical presentation of rhinitis sicca noted with this disease.
  
  
  CONCLUSIONS
  Nasal biopsy may be of use in antemortem diagnosis of grass sickness and identification of mucosal denervation; and might also be useful in the treatment of rhinitis in EGS cases.
authors.affiliation: The Division of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK.
authors.forename: D
authors.initials: D
authors.lastname: Prince
authors.forename: B M
authors.initials: BM
authors.lastname: Corcoran
authors.forename: I G
authors.initials: IG
authors.lastname: Mayhew
mesh_terms: D000208:Acute Disease; D000818:Animals; D001342:Autonomic Nervous System Diseases / Q000473:pathology / Q000662:veterinary*; D015415:Biomarkers / Q000032:analysis; D015740:Calcitonin Gene-Related Peptide / Q000032:analysis; D002908:Chronic Disease; D006734:Horse Diseases / Q000473:pathology*; D006736:Horses; D007150:Immunohistochemistry / Q000662:veterinary; D007381:Intermediate Filament Proteins / Q000032:analysis; D007382:Intermediate Filaments; D009297:Nasal Mucosa / Q000294:innervation*; D009412:Nerve Fibers / Q000737:chemistry*; D012220:Rhinitis / Q000473:pathology / Q000662:veterinary*; D013373:Substance P / Q000032:analysis; D013869:Thiolester Hydrolases / Q000032:analysis; D043222:Ubiquitin Thiolesterase
chemical_list: D015415:Biomarkers; D007381:Intermediate Filament Proteins; D013373:Substance P; D013869:Thiolester Hydrolases; D043222:Ubiquitin Thiolesterase; D015740:Calcitonin Gene-Related Peptide