title: Pulmonary response to airway instillation of autologous blood in horses.
abstract: BACKGROUND
  Exercise-induced pulmonary haemorrhage (EIPH) occurs in the majority of horses performing strenuous exercise. Associated pulmonary lesions include alveolar and airway wall fibrosis, which may enhance the severity of EIPH. Further work is required to understand the pulmonary response to blood in the equine airways.
  
  
  OBJECTIVE
  To confirm that a single instillation of autologous blood into horse airways is associated with alveolar wall fibrosis, and to determine if blood in the airways is also associated with peribronchiolar fibrosis.
  
  
  METHODS
  Paired regions of each lung were inoculated with blood or saline at 14 and 7 days, and 48, 24 and 6 h before euthanasia. Resulting lesions were described histologically and alveolar and airway wall collagen was quantified.
  
  
  RESULTS
  The main lesion observed on histology was hypertrophy and hyperplasia of type II pneumocytes at 7 days after blood instillation. This lesion was no longer present at 14 days. There were no significant effects of lung region, treatment (saline or autologous blood instillation), nor significant treatment-time interactions in the amount of collagen in the interstitium or in the peribronchial regions.
  
  
  CONCLUSIONS
  A single instillation of autologous blood in lung regions is not associated with pulmonary fibrosis.
  
  
  CONCLUSIONS
  Pulmonary fibrosis and lung remodelling, characteristic of EIPH, are important because these lesions may enhance the severity of bleeding during exercise. A single instillation of autologous blood in the airspaces of the lung is not associated with pulmonary fibrosis. Therefore the pulmonary fibrosis described in EIPH must have other causes, such as repetitive bleeds, or the presence of blood in the pulmonary interstitium in addition to the airspaces. Prevention of pulmonary fibrosis through therapeutic intervention requires a better understanding of these mechanisms.
authors.affiliation: Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan 48824, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Derksen
authors.forename: K J
authors.initials: KJ
authors.lastname: Williams
authors.forename: B D
authors.initials: BD
authors.lastname: Uhal
authors.forename: R F
authors.initials: RF
authors.lastname: Slocombe
authors.forename: H
authors.initials: H
authors.lastname: de Feijter-Rupp
authors.forename: S
authors.initials: S
authors.lastname: Eberhart
authors.forename: C
authors.initials: C
authors.lastname: Berney
authors.forename: N E
authors.initials: NE
authors.lastname: Robinson
mesh_terms: D000818:Animals; D005260:Female; D006470:Hemorrhage / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D006734:Horse Diseases / Q000473:pathology*; D006736:Horses; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D008297:Male; D005082:Physical Exertion; D011650:Pulmonary Alveoli / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D012720:Severity of Illness Index