A randomized controlled trial comparing non-steroidal anti-inflammatory and fusion protein inhibitors singly and in combination on the histopathology of bovine respiratory syncytial virus infection

• Published in: PloS one 2021-06, Vol.16 (6), p.e0252455-e0252455
• Main Authors: Carvallo Chaigneau, Francisco R, Walsh, Paul, Lebedev, Maxim, Mutua, Victoria, McEligot, Heather, Bang, Heejung, Gershwin, Laurel J
• Format: Article
• Language: English
• Subjects: Animals; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Antigens; Antiviral drugs; Biology and Life Sciences; Bovine respiratory disease complex; Calves; Care and treatment; Cattle; Clinical outcomes; Clinical trials; Complications and side effects; Data analysis; Editing; Electronic mail; Emergency medical care; Emergency medical services; Euthanasia; Evaluation; Experiments; Funding; Fusion protein; Health care facilities; Histochemistry; Histopathology; Immunology; Infections; Inflammation; Inoculation; Jugular vein; Medicine; Medicine and Health Sciences; Microbiology; Morbidity; Necropsy; Overdose; Pathology; Patient outcomes; Pentobarbital; Placebos; Pneumonia - drug therapy; Proteins; Public health; Respiratory agents; Respiratory diseases; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - drug therapy; Reviews; Veterinary colleges; Veterinary medicine; Viral Load; Viruses; Visualization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0252455

Bovine respiratory syncytial virus (RSV) has substantial morbidity in young calves, and closely parallels human RSV in infants. We performed a randomized controlled trial in five to six-week-old Holstein calves (Bos taurus). comparing fusion protein inhibitor (FPI) and non-steroidal anti-inflammatory drug (NSAID) singly and in combination at three and five days after experimental BRSV infection. Thirty-six calves received one of six treatments; Ibuprofen started on day 3, Ibuprofen started on day 5, FPI started on day 5, FPI and Ibuprofen started on day 3, FPI and Ibuprofen started on day 5, or placebo. We have previously reported significant clinical benefits when combined FPI and NSAID treatment was started at three and five days after bovine RSV infection. Necropsy was performed on Day 10 following infection and hematoxylin and eosin staining was performed on sections from each lobe. Histology was described using a four-point scale. We performed canonical discrimination analysis (CDA) to determine the structural level where differences between treatments occurred and mixed effects regression to estimate effect sizes. Separation from placebo was maximal for dual therapy at the levels of the alveolus, septum, and bronchus in CDA. We found that the clinical benefits of combined FPI and NSAID treatment of BRSV extend at least partially from histopathological changes in the lung when treatment was started three days after infection. We found decreased lung injury when ibuprofen was started as monotherapy on day 3, but not day 5 following infection. Combined therapy with both an FPI and ibuprofen was always better than ibuprofen alone. We did not prove that the clinical benefits seen starting FPI and ibuprofen five days after infection can be solely explained by histopathological differences as identified on H&E staining.