Original Research: Diffuse Lung Disease |

Chronic Pleuropulmonary Fibrosis and Elastosis of Aged DonkeysChronic Pleuropulmonary Fibrosis of Aged Donkeys: Similarities to Human Pleuroparenchymal Fibroelastosis

Amy Miele, BVM&S; Kevin Dhaliwal, MBChB, PhD; Nicole Du Toit, BVSc, PhD; John T. Murchison, MBChB, PhD; Catharine Dhaliwal, MBChB, PhD; Harriet Brooks, BVetMed, PhD; Sionagh H. Smith, BVMS, PhD; Nik Hirani, MBChB, PhD; Tobias Schwarz, DrMedVet; Chris Haslett, MBChB; William A. Wallace, MBChB, PhD; Bruce C. McGorum, BVM&S, PhD
Author and Funding Information

From the Medical Research Council Centre for Inflammation Research (Drs Miele, K. Dhaliwal, and Hirani and Prof Haslett), Queen’s Medical Research Institute, and Royal (Dick) School of Veterinary Studies and The Roslin Institute (Drs Smith and Schwarz and Prof McGorum), University of Edinburgh, Edinburgh, Scotland; The Donkey Sanctuary (Drs Du Toit and Brooks), Sidmouth, Devon, England; and Department of Radiology (Dr Murchison) and Department of Pathology (Drs C. Dhaliwal and Wallace), New Edinburgh Royal Infirmary, Edinburgh, Scotland.

Correspondence to: Bruce C. McGorum, BVM&S, PhD, The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush, Midlothian, Scotland, EH259RG; e-mail: bruce.mcgorum@ed.ac.uk

Drs Miele, K. Dhaliwal, and Wallace and Prof McGorum contributed equally.

Part of this article was presented in abstract form at the British Society of Animal Science Annual Meeting, April 16-17, 2013, Nottingham, England, and at the 7th Joint Meeting of the British Division of the International Academy of Pathology and the Pathological Society of Great Britain & Ireland, June 18-21, 2013, Edinburgh, Scotland.

Funding/Support: This study was funded by the Medical Research Council (MR/J014702/1).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Chest. 2014;145(6):1325-1332. doi:10.1378/chest.13-1306
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Background:  Donkey pulmonary fibrosis (DPF) is a spontaneous syndrome of aged donkeys with a high prevalence (35%). No previous detailed characterization of DPF has been performed. We sought to determine the similarities between DPF and recognized patterns of human pulmonary fibrosis.

Methods:  Whole lungs were collected from 32 aged donkeys at routine necropsy. Gross examination revealed pulmonary fibrosis in 19 donkeys (DPF cases), whereas 13 (control cases) had grossly normal lungs. Eighteen whole inflated ex vivo lungs (11 DPF cases, seven control cases) were imaged with high-resolution CT (HRCT) scan, whereas the remainder were sectioned and photographed. Tissue samples were collected from all lungs for histopathologic evaluation using a standardized protocol. HRCT images and histology sections underwent independent blinded review. Lung tissue was analyzed for herpes virus, fungal hyphae, mycobacteria, and dust content.

Results:  Ten of 19 DPF lungs were categorized as being consistent with pleuroparenchymal fibroelastosis (PPFE) according to previously defined histologic and imaging criteria. All 10 PPFE-like lungs had marked pleural and subpleural fibrosis, predominantly within the upper lung zone, with accompanying intraalveolar fibrosis and elastosis. Asinine herpesvirus was ubiquitously expressed within control and DPF lung tissue. No other etiologic agents were identified.

Conclusions:  Many cases of DPF share key pathologic and imaging features with human PPFE, a rare interstitial pneumonia. Consequently, further study of DPF may help to elucidate the etiopathogenesis of human PPFE.

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