Serum hepcidin as a clinical prognostic marker to discriminate the outcome of canine babesiosis

Abstract

Background: We aimed to identify the prognostic value of hepcidin in discriminating against the survival outcome of canine babesiosis. Methods: Semi-nested polymerase chain reaction was performed to confirm the presence of infection. Existence of oxidative stress and inflammatory response, changes in systemic iron status and hepcidin level were assessed in the study population. Based on the outcome Babesia infected dogs were classified into survivors (n=18) and non-survivors (n=14) of infection. 32 healthy dogs formed the control group. Conclusion: In non-survivors of infection, serum hepcidin was positively associated with C-reactive protein (P<0.01), serum iron (P<0.01), transferrin iron-binding capacity (P<0.05), unsaturated iron-binding capacity (P<0.01), thiobarbituric acid reactive substance (P<0.05) and negatively associated with catalase (P<0.01), zinc (P<0.01) and low haemoglobin density (P<0.01). The prognostic cut-off value of hepcidin in discriminating the survivability of infected dogs was 32.32 ng/mL with 100.00% specificity and 92.86% sensitivity. The area under the curve of hepcidin in discriminating survivability was about 0.984 and Youden's index was 0.928. Hence, hepcidin can predict the survival outcome of the disease enabling intensive care for animals with a cut-off value of hepcidin more than 32.32 ng/mL.