En medicina veterinaria se están extrapolando diversos marcadores de inflamación para su uso clínico. En el caballo, dada su alta susceptibilidad a las endotoxinas, es de vital importancia encontrar marcadores que permitan su tratamiento antes de que desarrollen signos clínicos irreversibles en muchas ocasiones. Con el fin de contribuir al desarrollo de estos marcadores, se han realizado cuatro estudios clínicos. En el primero se han analizado 82 caballos adultos, con enfermedades localizadas (Grupo A) y sistémicas (Grupo B). Además se incluyó un Grupo Control (Grupo 0) compuesto por 31 animales sanos. Los parámetros evaluados fueron: parámetros clínicos (frecuencia cardiaca, frecuencia respiratoria y temperatura rectal), parámetros bioquímicos (albúmina, creatinina, urea, proteínas totales, hierro y lactato plasmáticos) y hematología (hematocrito y recuento leucocitario total y diferencial). Los resultados obtenidos muestran que la concentración plasmática de hierro refleja de manera más sensible el estado de inflamación que el recuento total de leucocitos. La concentración plasmática de lactato permite identificar caballos críticos que requieren hospitalización. El segundo estudio se orienta en la búsqueda de marcadores que permitan diferenciar lesiones intestinales estrangulantes, obstructivas e inflamatorias con el objetivo de identificar parámetros que permitan diferenciar pacientes que necesitan cirugía. Se incluyeron 117 caballos mayores de 1 año de edad, con signos de dolor abdominal en el momento del ingreso, y 39 caballos sanos como Grupo Control. Los caballos enfermos se dividieron en función de la naturaleza de la lesión y también se clasificaron en función de la evolución. Se evaluó la concentración plasmática de hierro, lactato, fibrinógeno, recuento de leucocitos y varios parámetros clínicos. Los resultados obtenidos fueron: en el momento de admisión, los caballos con lesiones estrangulantes (61,51 ± 46,74 μg/dL) e inflamatorias (65,55 ± 43,08 μg/dL) mostraron la concentración plasmática de hierro más baja. Todos los enfermos mostraron concentraciones significativamente inferiores de hierro plasmático que los sanos (156,89 ± 47,51 μg/dL). Los no supervivientes presentaron una concentración de hierro inferior (52,64 ± 42,05 μg/dL) a los supervivientes (100,09 ± 69,34 μg/dL). La concentración plasmática de hierro no es útil para determinar la naturaleza del dolor abdominal, aunque puede ser empleada como marcador pronóstico. Los objetivos del tercer estudio fueron, por un lado, validar un sistema POC en la medida de cTnI y Dímero D en plasma de caballos y, por otro, determinar si las concentraciones de estos parámetros pueden ser de utilidad para distinguir animales sanos de enfermos, como marcadores de pronóstico o para monitorizar el tratamiento de caballos hospitalizados. Se obtuvieron aumentos significativos (P < 0,05) para ambos parámetros en caballos enfermos en el momento de admisión, a pesar que las diferencias no fueron estadísticamente significativas en función de la evolución (cTnI: control: 0,014 ± 0,01 μg/mL, supervivientes: 0,27 ± 0,37 μg/mL, no-supervivientes: 0,60 ± 1,21 μg/mL; Dímero D: control: 104,90 ± 30,82 ng/mL, supervivientes: 1.217,22 ± 1.213,28 ng/mL, no-supervivientes: 1.613,67 ± 1.426,75 ng/mL). Después del tratamiento hospitalario no existieron diferencias significativas en las concentraciones de cTnI y Dímero D entre supervivientes (cTnI: 0,04 ± 0,06 μg/mL; Dímero D: 958,80 ± 686,65 ng/mL) y no-supervivientes (cTnI: 0,70 ± 1,47 μg/mL; Dímero D: 1.875,30 ± 801,83 ng/mL). Teniendo en cuenta la naturaleza de las lesiones (inflamatoria, obstructiva o estrangulante) no existieron diferencias significativas para los dos parámetros en el momento de la admisión (cTnI: I: 0,83 ± 1,35 μg/mL, S: 0,26 ± 0,39 μg/mL, O: 0,24 ± 0,44 μg/mL; Dímero D: I: 909,78 ± 651,39 ng/mL, S: 1.483,00 ± 1.762,68 ng/mL, O: 1.855,50 ± 1.646,46 ng/mL) ni tras la hospitalización (cTnI: I: 0,56 ± 1,48 μg/mL, S: 0,34 ± 0,77 μg/mL, O: 0,02 ± 0,01 μg/mL; Dímero D: I: 1.565,11 ± 2.733,88 ng/mL, S: 1.288,14 ± 819,24 ng/mL, O: 1.309,50 ± 842,10 ng/mL). El sistema POC para la medición de cTnI y Dímero D puede ser de utilidad en la clínica equina, ya que es una herramienta práctica, simple y mínimamente invasiva para evaluar caballos críticos en el momento del ingreso. El cuarto trabajo consistió en evaluar el recuento de eosinófilos como marcador de SRIS en caballos críticos. Para ello se incluyeron 63 caballos adultos con dolor abdominal divididos en dos Grupos, en función de la presencia o ausencia de respuesta inflamatoria sistémica. El recuento de eosinófilos se realizó en el momento del ingreso. Los resultados del recuento de eosinófilos y de las concentración plasmática de lactato difieren entre los dos Grupos, siendo el recuento de eosinófilos significativamente menor en el Grupo de los caballos con SRIS. El recuento de eosinófilos tuvo el mismo valor discriminativo que el lactato y también puede usarse como marcador de pronóstico El valor predictivo negativo de la eosinopenia puede resultar de utilidad como marcador de pronóstico.Conclusiones1. La disminución de la concentración de hierro plasmático en el caballo es útil en el diagnóstico de enfermedades inflamatorias, si bien no discrimina entre enfermedades localizadas y sistémicas. 2. De los marcadores tradicionales estudiados, recuento total de leucocitos, hematocrito, concentración plasmática de proteínas totales, concentración plasmática de albúmina y concentración plasmática de lactato, este último es el más fiable como indicador de gravedad, permitiendo identificar caballos críticos. 3. El equipo AQT90 FLEX es suficientemente preciso y fiable para ser empleado en la medición en plasma de cTnI y Dímero D en Unidades de Cuidados Intensivos equinas. 4. La medida de la concentración plasmática de cTnI y de Dímero D resulta de utilidad en la identificación de pacientes críticos en el momento del ingreso, aunque se requieren más estudios para valorar su utilidad en la monitorización durante la hospitalización. 5. El recuento de eosinófilos tiene valor discriminativo para identificar caballos con SRIS y endotoxemia. La eosinopenia puede considerarse como indicador de mal pronóstico en caballos críticos.6. 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