Functional phenotype and its correlation with therapeutic response and inflammatory type of bronchoalveolar lavage fluid in feline lower airway disease

Abstract

Background: Currently, functional assessment to monitor therapeutic response in feline lower airway disease (FLAD) has limited application. Objectives: To evaluate if expiratory indices derived from pseudo-tidal breathing flow-volume loop (pTBFVL) representing lower airway obstruction would decrease after clinical improvement and to investigate the correlation between functional phenotype and inflammatory cell type in bronchoalveolar lavage (BAL) fluid. Animals: Nineteen client-owned cats with FLAD. Methods: Prospective observational study. Functional assessment with pTBFVL indices (eg, peak to mid-expiratory flow; PEF/EF50) and conventional barometric whole body plethysmography (BWBP) parameters (eg, enhanced pause) was carried out before receiving treatment. BAL was performed to analyze inflammatory cell types. Signs were assessed by scoring. The cats were treated with glucocorticoids daily and functional testing was repeated. Results: Loop indices PEF/EF50 and PEF/EF25 were significantly decreased after treatment (P 1.51 before treatment had a significantly higher granulocyte (eosinophil plus neutrophil) percentage in BAL fluid (P = .014). Granulocyte percentage in BAL fluid was strongly correlated with PEF/EF25 (P = .001, rs = 0.74) and moderately correlated with PEF/EF50 (P = .022, rs = 0.57), whereas eosinophil or neutrophil percentage alone had no significant correlation with functional parameters. Conclusions and Clinical Importance: Functional parameters including PEF/EF50 and PEF/EF25 can be used for monitoring therapeutic response. The presence of airflow limitation during mid- to late expiration is affected by the overall extent of granulocyte infiltration.