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Roberto Farina - Fatro
• Cow metabolism during transition
• Fatty liver and related disorders
• Transcriptional control of lipid/energy
metabolism: PPARs
• PPAR-alpha agonists in veterinary
The last 3 wk before to 3 wk after parturition
 Tremendous metabolic adaptations to support lactation
 Most diseases occur during or soon after this time
Prepartum Postpartum Increase
Hepatic Blood Flow 1140 l/h 2099 l/h + 84%
DMI 9.8 kg/d 14.1 kg/d + 44 %
Liver Oxygen Utilization 1619 mmol/h 3159 mmol/h + 95 %
Daily Metabolic Activity
per gram of liver
4.4 mmol O2/g 8.6 mmol O2/g X 2
Glucose Release from
Liver
1356 g/d 2760 g/d X 2
Big changes over a very short time highlight the tremendous
metabolic adaptations necessary to adequately support lactation
-10
0
10
20
30
40
0 35 70 105 140 175 210 245 280
Energy Ingested
Energy Required
NegativePositive
Energy Balance = Energy Ingested - Energy Required
DIM
Mcal/day
Adapted from Bauman and Currie 1980
After parturition extra energy
requirement for milk production
is not met by feed energy intake
Lipolisis
Parturition
HSL
CO2
CO2
CO2
CO2
↓ Insulin
↑ epinephrine
Lipolisis
0%
2%
4%
6%
8%
10%
12%
14%
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
-17 -10 -3 4 11 18 25
LiverTG-%DM
NEFAmEq/L
Days
NEFA Liver TGParturition
Adapted from Overton 2003
Fatty liver is a common condition, up to 50 % of dairy cows
Fatty liver has detrimental effects on
health, productivity and fertility
The Liver sits at the crossroads of
metabolism
Its integrity is vital to all physiological
processes
Disorder Association Reference
Displaced abomasum +++ Wada et al., 1995; Rehage et al., 1996
Impaired immunoreactivity ++ Wentink et al., 1997; Zerbe et al.,
2000
Ketosis +++ Gröhn et al., 1987; Veenhuizen et al.,
1991
Laminitis + Fronk et al., 1980; Rehage et al., 1996
Mastitis ++ Morrow et al., 1979
Metritis ++ Haraszti et al., 1982; Heinonen et al.,
1987
Milk fever + Higgins and Anderson, 1983; Gröhn et
al., 1987
Retained placenta + Haraszti et al., 1982; Heinonen et al.,
1987
Bobe 2004
Curtis 1989
Mastitisincidence(30days)
Hepatic fat increment
(2 wk after vs. 2 wk before calving)
Parameter Association Reference
First ovarian activity ++ Reid et al., 1983; Rukkwamsuk et al., 1999c
First ovulation + Reid et al., 1983
First estrus + Paulová et al., 1990; Jorritsma et al., 2000
First insemination + Reid et al., 1983
Days open ++ Heinonen et al., 1987; Paulová et al., 1990
Pregnancy rate ++ Haraszti et al., 1982; Jorritsma et al., 2000
Services/cow + Schäfer et al., 1988; Paulová et al., 1990
Bobe 2004
• All the cells regulate their metabolism in
response to changes in the environment and
metabolize fuels according to their availability
MODERN VIEW
Nutrients can directly
regulate metabolism in a
hormonal independent
manner
CLASSICAL VIEW
metabolic adaptations
are controlled only by
hormonal or neuronal
signals
PPARs
Peroxisome Proliferator-Activated Receptors
Fat sensors transducing changes in cellular lipid
levels to the transcriptional regulation of target
genes involved in fatty acid metabolism
NUCLEAR RECEPTOR LIGAND
Thyroid hormone R Thyroid hormone
Glucocorticoid R Cortisol
Estrogen R Estrogen
Progesterone R Progesterone
Androgen R Testosterone
PPAR Lipids
Receptors found
within the nucleus
Bind directly to DNA
and regulate gene
expression
Ligand activated
transcription factors
• Nuclear receptors
involved in the
transcriptional regulation
of lipid metabolism and
energy balance
• Fatty acids and their
derivatives (Acyl-CoA &
eicosanoids) are the
natural ligands of PPAR
ANIMATION
PPARα
PPARδ PPARγ
STORAGE
FAT
energy
BURNING
FAT
energy
Acts in liver to maintain hepatic lipid
homeostasis and reduces fat concentrations
Peroxisomal
β-oxidation
Mitochondrial
β-oxidation
NEFA
Transport
NEFA
Uptake
↑ epinephrine
↓ Insulin
Lipolisis
HSL
CO2
CO2
CO2
CO2
• fenofibrate, gemfibrozil
• used to lower triglycerides and raise
HDL-C in dyslipidemia to reduce risk of
cardiovascular events
• 2-phenoxy-2-methyl-propionic acid
• Hepagen
• used to treat fatty liver, related metabolic
disorders and improve energy balance
2-methyl-2-phenoxy-propionic acid
2-methyl-2-phenoxy-propanoic acid
2-Phenoxyisobutyric acid
2,2-Dimethylphenoxyacetic acid
Mefepronic acid
O C
CH3
CH3
C
OH
O
40 Holstein cows (2°-5° lactation)
• Treated group: 50 ml of Hepagen® I.M. at calving, 3d postpartum and 5d postpartum
• Control group: 50 ml of physiological solution (NaCl 0.9%)/ head at calving, 3d
postpartum and 5d postpartum
50ml/cow
50ml/cow
50ml/cow
Biopsy
Biopsy
Biopsy
Liver sections stained with toluidine blue
Sciorsci 2009
30 μm
CONTROLTREATED
1 d 15 d 30 d
8.6%
9.0%
0.3% 0.1%
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
15 d 30 d
Liver Fat
Control
Treated
P < 0.001
Liver sections stained with haematoxylin-PAS to highlight the presence of glycogen (purple). Sciorsci 2009
30 μm
CONTROLTREATED
1 d 15 d 30 d
26
27
28
29
30
31
32
33
34
35
36
1 3 5 10 15 30 40
g/L
Days from parturition
Control
Hepagen
• Albumin concentration significantly higher in the treated group
• Albumin concentration in the control group slightly lower than the normal range
3.70 4.24
5,46
6.47
-
2
4
6
8
11 d 13 d
ng/ml
Progesterone
74
50
-
20
40
60
80
days
Days to 1° Heat
121
92
-
50
100
150
days
Days open
50
6457
71
-
20
40
60
80
days
Pregnancy rate
Sciorsci 2009p<0.05
HEPAGENCONTROL
36 Holstein cows (2°- 4° lactation)
50ml/cow
50ml/cow
50ml/cow
BHB
BHB
BHB
BHB
Bouda et al. 2008
0.4
0.6
0.8
1.0
1.2
-10 10 30 40
BHBmmol/L
44%
39%
28%
17%
6% 6%
0%
25%
50%
10 30 40
CONTROL
HEPAGEN
Bouda et al. 2008
p<0.05
Open days: lower in Control than in Treated group
109.9 vs. 118.5 days
57 Pluriparous Holstein cows
50ml/cow
50ml/cow
BHB
BHB
BHB
Aparicio et al. 2009
BHB
BHB
CONTROL BCS: 3.25 – 3.75 TREATED BCS: 3.25 – 3.75
CONTROL BCS: ≥ 4 TREATED BCS: ≥ 4
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
-10 -7 2 10 21
CONTROL BCS ≥ 4
CONTROL BCS: 3.25 – 3.75
HEPAGEN BCS ≥ 4
HEPAGEN BCS: 3.25 – 3.75
200 “Parmigiano-Reggiano” cows
50ml/cow
50ml/cow
Gorrieri 2009
BHB once/week
Follow Up (postpartum diseases, fertility)
30 %
15 %
0%
10%
20%
30%
40%
Postpartum Diseases
0.86
0.35
0.0
0.2
0.4
0.6
0.8
1.0
BHBmg/dl
Milk BHB
89
76
50
60
70
80
90
100
days
Days open
25 %
10 %
0%
10%
20%
30%
BHB +
metritis, displaced abomasum
Gorrieri 2009
Monitor and record for diseases occurring during the early
lactation period in the herd:
• Lactational incidence risk (LIR): #affected / # of calvings (at
risk) in the same time period
• Case definitions/Confidence of diagnosis grade
• Define targets for acceptable levels of incidence
Reduce risk of
postpartum diseases
To complement transition cow management programs and
herd preventive health care programs
50ml/cow
50ml/cow
Cows at a higher risk of fatty liver and metabolic
disordes:
 Over-conditioned
 Underfed
 Quick weight loss
 Calving difficulties, Twins
 Predisposing diseases (Infections, RP, etc.)
Identify primary target for
prevention
50ml/cow
50ml/cow
Daily Monitoring of Each Cow for First 10
Days after Calving
(Temperature and Physical Exam)
Early Identification and Treatment of
Problem Cows
Best with Fresh Cow
Medicine Programs
• Difficult
• No specific symptoms
• Diagnosed by biopsy
–invasive technique
–hemorrhage, infection, death
• New promising ultrasound technology
• Cows having problems from the beginning of
lactation
• Rapid weight and BCS loss, reduced feed intake
• Presence of ther diseases
• Diseases more severe and less responsive
– Milk fever cows that relapse and become downers
– Ketotic cows that don’t respond to treatment
– Chronic mastitis cows
– Repeat breeders that defy all treatments
– Cows that relapse or go from one disease to another
– Reduced milk production
– Cows that are frequently culled
50ml/cow
Follow up and repeat
where appropriate
50ml/cow
Hepagen - Metabolic Management of Cow Health

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Hepagen - Metabolic Management of Cow Health

  • 2. • Cow metabolism during transition • Fatty liver and related disorders • Transcriptional control of lipid/energy metabolism: PPARs • PPAR-alpha agonists in veterinary
  • 3. The last 3 wk before to 3 wk after parturition  Tremendous metabolic adaptations to support lactation  Most diseases occur during or soon after this time
  • 4. Prepartum Postpartum Increase Hepatic Blood Flow 1140 l/h 2099 l/h + 84% DMI 9.8 kg/d 14.1 kg/d + 44 % Liver Oxygen Utilization 1619 mmol/h 3159 mmol/h + 95 % Daily Metabolic Activity per gram of liver 4.4 mmol O2/g 8.6 mmol O2/g X 2 Glucose Release from Liver 1356 g/d 2760 g/d X 2 Big changes over a very short time highlight the tremendous metabolic adaptations necessary to adequately support lactation
  • 5. -10 0 10 20 30 40 0 35 70 105 140 175 210 245 280 Energy Ingested Energy Required NegativePositive Energy Balance = Energy Ingested - Energy Required DIM Mcal/day Adapted from Bauman and Currie 1980 After parturition extra energy requirement for milk production is not met by feed energy intake Lipolisis Parturition
  • 7. 0% 2% 4% 6% 8% 10% 12% 14% 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 -17 -10 -3 4 11 18 25 LiverTG-%DM NEFAmEq/L Days NEFA Liver TGParturition Adapted from Overton 2003
  • 8. Fatty liver is a common condition, up to 50 % of dairy cows
  • 9. Fatty liver has detrimental effects on health, productivity and fertility The Liver sits at the crossroads of metabolism Its integrity is vital to all physiological processes
  • 10. Disorder Association Reference Displaced abomasum +++ Wada et al., 1995; Rehage et al., 1996 Impaired immunoreactivity ++ Wentink et al., 1997; Zerbe et al., 2000 Ketosis +++ Gröhn et al., 1987; Veenhuizen et al., 1991 Laminitis + Fronk et al., 1980; Rehage et al., 1996 Mastitis ++ Morrow et al., 1979 Metritis ++ Haraszti et al., 1982; Heinonen et al., 1987 Milk fever + Higgins and Anderson, 1983; Gröhn et al., 1987 Retained placenta + Haraszti et al., 1982; Heinonen et al., 1987 Bobe 2004
  • 11. Curtis 1989 Mastitisincidence(30days) Hepatic fat increment (2 wk after vs. 2 wk before calving)
  • 12. Parameter Association Reference First ovarian activity ++ Reid et al., 1983; Rukkwamsuk et al., 1999c First ovulation + Reid et al., 1983 First estrus + Paulová et al., 1990; Jorritsma et al., 2000 First insemination + Reid et al., 1983 Days open ++ Heinonen et al., 1987; Paulová et al., 1990 Pregnancy rate ++ Haraszti et al., 1982; Jorritsma et al., 2000 Services/cow + Schäfer et al., 1988; Paulová et al., 1990 Bobe 2004
  • 13.
  • 14. • All the cells regulate their metabolism in response to changes in the environment and metabolize fuels according to their availability MODERN VIEW Nutrients can directly regulate metabolism in a hormonal independent manner CLASSICAL VIEW metabolic adaptations are controlled only by hormonal or neuronal signals
  • 15. PPARs Peroxisome Proliferator-Activated Receptors Fat sensors transducing changes in cellular lipid levels to the transcriptional regulation of target genes involved in fatty acid metabolism
  • 16. NUCLEAR RECEPTOR LIGAND Thyroid hormone R Thyroid hormone Glucocorticoid R Cortisol Estrogen R Estrogen Progesterone R Progesterone Androgen R Testosterone PPAR Lipids Receptors found within the nucleus Bind directly to DNA and regulate gene expression Ligand activated transcription factors
  • 17. • Nuclear receptors involved in the transcriptional regulation of lipid metabolism and energy balance • Fatty acids and their derivatives (Acyl-CoA & eicosanoids) are the natural ligands of PPAR ANIMATION
  • 18.
  • 20. Acts in liver to maintain hepatic lipid homeostasis and reduces fat concentrations Peroxisomal β-oxidation Mitochondrial β-oxidation NEFA Transport NEFA Uptake
  • 22. • fenofibrate, gemfibrozil • used to lower triglycerides and raise HDL-C in dyslipidemia to reduce risk of cardiovascular events • 2-phenoxy-2-methyl-propionic acid • Hepagen • used to treat fatty liver, related metabolic disorders and improve energy balance
  • 23. 2-methyl-2-phenoxy-propionic acid 2-methyl-2-phenoxy-propanoic acid 2-Phenoxyisobutyric acid 2,2-Dimethylphenoxyacetic acid Mefepronic acid O C CH3 CH3 C OH O
  • 24.
  • 25. 40 Holstein cows (2°-5° lactation) • Treated group: 50 ml of Hepagen® I.M. at calving, 3d postpartum and 5d postpartum • Control group: 50 ml of physiological solution (NaCl 0.9%)/ head at calving, 3d postpartum and 5d postpartum 50ml/cow 50ml/cow 50ml/cow Biopsy Biopsy Biopsy
  • 26. Liver sections stained with toluidine blue Sciorsci 2009 30 μm CONTROLTREATED 1 d 15 d 30 d 8.6% 9.0% 0.3% 0.1% 0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10% 15 d 30 d Liver Fat Control Treated P < 0.001
  • 27. Liver sections stained with haematoxylin-PAS to highlight the presence of glycogen (purple). Sciorsci 2009 30 μm CONTROLTREATED 1 d 15 d 30 d
  • 28. 26 27 28 29 30 31 32 33 34 35 36 1 3 5 10 15 30 40 g/L Days from parturition Control Hepagen • Albumin concentration significantly higher in the treated group • Albumin concentration in the control group slightly lower than the normal range
  • 29. 3.70 4.24 5,46 6.47 - 2 4 6 8 11 d 13 d ng/ml Progesterone 74 50 - 20 40 60 80 days Days to 1° Heat 121 92 - 50 100 150 days Days open 50 6457 71 - 20 40 60 80 days Pregnancy rate Sciorsci 2009p<0.05 HEPAGENCONTROL
  • 30. 36 Holstein cows (2°- 4° lactation) 50ml/cow 50ml/cow 50ml/cow BHB BHB BHB BHB Bouda et al. 2008
  • 31. 0.4 0.6 0.8 1.0 1.2 -10 10 30 40 BHBmmol/L 44% 39% 28% 17% 6% 6% 0% 25% 50% 10 30 40 CONTROL HEPAGEN Bouda et al. 2008 p<0.05 Open days: lower in Control than in Treated group 109.9 vs. 118.5 days
  • 32. 57 Pluriparous Holstein cows 50ml/cow 50ml/cow BHB BHB BHB Aparicio et al. 2009 BHB BHB CONTROL BCS: 3.25 – 3.75 TREATED BCS: 3.25 – 3.75 CONTROL BCS: ≥ 4 TREATED BCS: ≥ 4
  • 33. 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 -10 -7 2 10 21 CONTROL BCS ≥ 4 CONTROL BCS: 3.25 – 3.75 HEPAGEN BCS ≥ 4 HEPAGEN BCS: 3.25 – 3.75
  • 34. 200 “Parmigiano-Reggiano” cows 50ml/cow 50ml/cow Gorrieri 2009 BHB once/week Follow Up (postpartum diseases, fertility)
  • 35. 30 % 15 % 0% 10% 20% 30% 40% Postpartum Diseases 0.86 0.35 0.0 0.2 0.4 0.6 0.8 1.0 BHBmg/dl Milk BHB 89 76 50 60 70 80 90 100 days Days open 25 % 10 % 0% 10% 20% 30% BHB + metritis, displaced abomasum Gorrieri 2009
  • 36.
  • 37. Monitor and record for diseases occurring during the early lactation period in the herd: • Lactational incidence risk (LIR): #affected / # of calvings (at risk) in the same time period • Case definitions/Confidence of diagnosis grade • Define targets for acceptable levels of incidence Reduce risk of postpartum diseases To complement transition cow management programs and herd preventive health care programs
  • 39. Cows at a higher risk of fatty liver and metabolic disordes:  Over-conditioned  Underfed  Quick weight loss  Calving difficulties, Twins  Predisposing diseases (Infections, RP, etc.) Identify primary target for prevention
  • 41. Daily Monitoring of Each Cow for First 10 Days after Calving (Temperature and Physical Exam) Early Identification and Treatment of Problem Cows Best with Fresh Cow Medicine Programs
  • 42. • Difficult • No specific symptoms • Diagnosed by biopsy –invasive technique –hemorrhage, infection, death • New promising ultrasound technology
  • 43. • Cows having problems from the beginning of lactation • Rapid weight and BCS loss, reduced feed intake • Presence of ther diseases • Diseases more severe and less responsive – Milk fever cows that relapse and become downers – Ketotic cows that don’t respond to treatment – Chronic mastitis cows – Repeat breeders that defy all treatments – Cows that relapse or go from one disease to another – Reduced milk production – Cows that are frequently culled
  • 44. 50ml/cow Follow up and repeat where appropriate 50ml/cow