Table 5.

Time course relationship between main transition period diseases, their effect on physiological imbalance conditions and possible secondary diseases triggered from it

Primary	Effect on physiological imbalance	Secondary	References
Retained placenta	Raise of PIC1; depression of DMI2; increase of NEB3 and lipomobilization; acute phase response	Mastitis, ketosis	Dohoo and Martin, 1984a; Emanuelson et al., 1993; Trevisi and Bertoni, 2008
Ketosis	Ketone bodies production; depression of DMI2; increase of NEB3; impairment of immune functions; decrease of vitamin A and increase of bilirubin	Mastitis, metritis, left displacement of abomasum	Oltenacu and Ekesbo, 1994; Duffield, 2000; Rodriguez-Jimenez et al., 2018
Milk fever	Depression of DMI2; increase of NEB3 and lipomobilization; decreased smooth muscle function (essential for digestive tract); increased cortisol secretion	Ketosis; left displacement of abomasum; retained placenta	Dohoo and Martin, 1984b; Loor et al., 2013; Esposito et al., 2014
Left displacement of abomasum	Depression of DMI2; increase of NEB3 and lipomobilization	Ketosis	Dohoo and Martin, 1984a
Fatty liver	Increased haptoglobin production and inflammation; increased PIC1 production; depression of DMI2; increase of NEB3 and lipomobilization; acute phase response	Metritis, laminitis, displacement of abomasum, mastitis	Van Winden and Kuiper, 2003; Ametaj et al., 2005; Bertoni et al., 2006a
Infectious diseases	Decreased glutamine concentrations due to tissue and immune cells consumption; repression of genes related to inflammatory response and PMN4 chemotaxis; greater expression of mRNA for anti-inflammatory genes and oxidative stress	Metritis, mastitis, infectious diseases	Holtenius et al., 2004; Moyes et al., 2009

¹Pro-inflammatory cytokines.

² Dry matter intake.

³Negative energy balance.

⁴Polymorphonuclear cells.