title: Development of a Semiquantitative Histological Score for the Diagnosis of Heaves Using Endobronchial Biopsy Specimens in Horses.
abstract: BACKGROUND
  Remodeling of the peripheral airways persists during the asymptomatic phase of heaves. Assessing the histology of large bronchi could facilitate the diagnosis of heaves during remission of the disease.
  
  
  OBJECTIVE
  Airway inflammation and remodeling in endobronchial biopsy (EBB) specimens differentiate horses with heaves from controls, independently of their clinical status (exacerbation or remission).
  
  
  METHODS
  Fourteen healthy horses and 24 horses with heaves.
  
  
  METHODS
  A 14-point scoring system assessing central bronchial wall inflammation and remodeling was developed. The score was validated by 2 pathologists using specimens obtained from 18 horses (6 controls, 6 with heaves exacerbation, and 6 with heaves remission) in which lung function had been assessed with impulse oscillometry. Clinical and research application of the score was evaluated using biopsy specimens obtained from 20 additional horses (8 controls, 6 with heaves exacerbation, and 6 with heaves remission).
  
  
  RESULTS
  The score was repeatable (interclass correlation coefficient = 69%). It differentiated horses with heaves in exacerbation (mean ± SD: 6.2 ± 2.2) from those in remission (4.0 ± 1.0) and controls (3.6 ± 1.7, P < 0.0001). The histological scores of horses with heaves correlated with the ratio of respiratory resistance (R) at 5 and 10 Hz (R5: R10ratio, r = 0.65, P = 0.03), a parameter assessing airway obstruction.
  
  
  CONCLUSIONS
  The proposed histological scoring system correlates with the degree of airway obstruction measured by impulse oscillometry. However, it does not discriminate horses with heaves in remission from controls. Evaluation of EBB specimens might be considered in future research and clinical studies of respiratory diseases in horses.
authors.affiliation: Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Bullone
authors.affiliation: Department of Pathology and Microbiology, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, QC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Hélie
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, QC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Joubert
authors.affiliation: Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, QC, Canada. jean-pierre.lavoie@umontreal.ca.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavoie
mesh_terms: D000818:Animals; D001706:Biopsy / Q000662:veterinary; D001980:Bronchi / Q000473:pathology*; D006734:Horse Diseases / Q000145:classification* / Q000473:pathology*; D006736:Horses; D008173:Lung Diseases, Obstructive / Q000473:pathology / Q000662:veterinary*
keywords: 
  RAO
  ; Airway; Equine asthma; Inflammation; Lung; remodeling