Thursday, October 27, 2005

James Belknap: Questioning a Foot's Inflammatory Response

Note: In April, I was lucky to catch up with Dr Jim Belknap in his office at Ohio State and learn about his research. A small bit of it is summarized here. He is one of the main presenters in the scientific sessions in Palm Beach and this modest overly-simplified summary should give you some idea of research focus. He did an excellent job of explaining it to me, and convinced me that this is an interesting aspect of laminitis worthy of our attention. I think you will agree!

COLUMBUS, OHIO--Dr. James Belknap peeks out of his laboratory at the Ohio State University College of Veterinary Medicine. He is surrounded by piles of files, binders full of slides, and a head full of ideas about what laminitis may be all about.

For years, Dr. Belknap has been perplexed by the severe laminitis cases encountered in veterinary college hospitals. These are not your foundered ponies in the field down the street. They are high profile, devastating cases of sudden and severe laminitis secondary to colitis, colic surgery, retained placentas in mares, or Potomac Horse Fever.

Like all researchers, Belknap understood that laminitis is a disease of the whole horse, but like the others, he questioned--rather than accepted--why the foot was the most severely affected part of the body. If the whole horse was suffering a dramatic medical insult, why did only the foot show the damage? Why did the laminae (tiny fibers that hold the hoof wall to the inner foot) rip apart, while other, similar connective tissue in the body remained intact?

Seeking alliances with other researchers working on equine and human disease, Belknap has opened new chapters in laminitis research with pioneering work on the inflammation process in laminitis. He has identified the disparity in inflammation sensors called leukocytes in the laminae of horse's foot that make it unique in the entire horse's body. While other tissues in the horse are able to cope with massive disruptions in cell metabolism, the foot lacks their anti-inflammatory defenses. "It is as if the foot is immune-compromised," he muses.

Belknap looks to human medicine for clues, and in particular to studies devoted to Systemic Inflammatory Response Syndrome (SIRS), a deadly infection that attacks human hospital patients, to see how the body's immune system fights off inflammation. While science cannot change the cellular structure of the foot, medications that aggressively reduce or bypass the inflammatory response may lessen damage to the hoof tissues in horses at high risk for acute laminitis.

Belknap's piles will get higher before they shrink but his unique approach to research on the hoof has the potential to change the face of laminitis treatment.

Notes: Some of the text above appeared in the article "Laminitis Battle Stations" in a recent issue of Practical Horseman magazine.

To learn more:
(This is a link to an easy-to-read summary of Dr. Belknap's earlier research when he was at Auburn University.)

Other papers are posted on (You will need to sign up as a member in order to access these papers but we should all support IVIS anyway!).

Several of Dr. Belknap's papers are published in the Equine Veterinary Journal's special collection of recent papers on laminitis; this volume is sold individually through Hoofcare & Lameness at a cost of $30 plus $5 post.

Farrier and horse owner attendees: If I can understand this research, you can too! Don't rule out the scientific sesssions for some information that will help you learn more about the unique metabolism and physiology of tissue in the foot. It may inspire you to read more and learn more and become involved in research or fundraising for the scientific session presenters.