Breakthrough Laminitis Research Shows Promise for the Future

Horse owners usually dread hearing the diagnosis of “Laminitis.” The disease plagues horses of many backgrounds, ages and disciplines. Using genetics, UF/IFAS and University of Pennsylvania scientists have made a breakthrough in the disease thanks to funding from The Foundation for the Horse.

A horse’s hoof has a tough job. It must support a heavy animal which can move faster than 40 mph. Laminitis occurs when inflammation and damage of the tissue takes place between the hoof and coffin bone. It causes lameness, a diminished quality of life and often results in euthanasia.

“Laminitis is a tough problem for the horse and its owner,” said Samantha Brooks, UF/IFAS associate professor of equine physiology. “We have very few tools in our arsenal to manage the disease itself. We treat symptoms, pain and mechanical instability but do not have anything to target the cause just yet.”

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Laminitis studies have previously been hindered by the scarcity of genetic information specific to hoof tissues. Scientists tapped into the University of Pennsylvania’s New Bolton Center Laminitis Discovery Database, an archive of data and sample sets from naturally occurring laminitis cases collected since 2008. Using that database, researchers examined 36 archived tissues of 20 Thoroughbred horses treated for laminitis.

There are three types of laminitis, and all impair the structure and function of the horse’s foot. This research provided a snapshot of the active pathways and functions of the hoof, with a focus on supporting limb laminitis – the laminitis to which famous racehorse Barbaro succumbed.

“We understand the situations that trigger an episode of laminitis, but we do not have a good understanding of what is happening in the hoof,” said Brooks. “This study took a very comprehensive view of the processes early in the development of laminitis.”

Using gene expression analysis, researchers catalogued the changes in gene transcription across the 20 horses. Some had healthy feet, some were early in the disease process and others were more severe. Researchers identified trends in the disease process.

“By tapping into my lab’s database and incorporating Dr. Brooks’ unparalleled expertise in equine genetics and transcriptome analysis, we have identified new and promising pathways in cell stress and inflammatory response that significantly enhance our understanding of supporting limb laminitis and its disease processes,” said Hannah Galantino-Homer, VMD, PhD, DACT, senior investigator in Laminitis Research at Penn Vet’s New Bolton Center.

The research resulted in three key findings.

The first related to keratin, an important structural protein that helps maintain the structural integrity of materials like hair, nails and horse hooves. This study was one of the first to examine the changes in the keratin family through the laminitis disease process. Some of the keratin-related genes and regulation of the cell’s manufacturing process started to diminish as the disease began. This could be compared to when a car gets a flat tire; it may still be running but it loses appropriate function and slows down.

Another type of cell machinery often studied in laminitis are a class of enzymes called metalloproteinases; enzymes that help maintain the cytoskeleton. These enzymes must maintain a careful balance. Hooves must be able to grow and not break down under the weight of the horse, which requires a balance of remodeling and building tissues within the hoof. When the metalloproteinases become too active, the hoof begins to lose structural strength. One previous theory for treating this process was to stop these enzymes from becoming too active. But treatment targeted these enzymes might also stop hoof growth, which would likely lead to further issues.

When keratin degrades, inflammation in the hoof leads to laminitis. Scientists found a collection of genes responsible for triggering that inflammation which could pave the way for future medications to treat the inflammation. The genes led researchers to believe that some human inflammatory medications for autoimmune disorders may help horses with laminitis.

Brooks hopes that this research can lead to a blood test to detect these new laminitis-related biomarkers, and medications that are economical and effective for horses suffering from the disease.

Changes in gene expression in diseased tissue are often reflected in changes in the proteins that can be detected in the blood as the disease progresses. For example, specific proteins, or biomarkers, that increase in the blood in humans following traumatic brain injury had increased expression in the samples from the horses with laminitis in this study. Medical doctors have used these compounds to understand the severity of these injuries in humans without using imaging or more invasive testing. Brooks hopes this could be used as a tool to monitor the progression of laminitis in the horse.

“We don’t always recognize that a horse has severe laminitis until things have gotten quite bad,” said Brooks. “Early monitoring tools and ways to combat the disease were exciting findings, but we need further research before these new tools will be ready for use in the field.”

Brooks hopes that this research can lead to a blood test to detect these new laminitis-related biomarkers, and medications that are economical and effective for horses suffering from the disease.

“Ultimately, these new findings point us towards a more targeted approach for future exploration that we hope will help uncover novel solutions for preventing and treating this debilitating disease,” said Galantino-Homer.

“This is a big step in improving our understanding of laminitis,” said Brooks. “Something that could be completely untreatable ten years ago; in another ten years we may be able to intervene and make a significant difference in the disease early on.”

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Reprinted with permission – University of Pennsylvania, School of Veterinary Medicine