Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells

Abstract

Adipose-derived stem and regenerative cells (ADRCs), concentrated from autologous fat tissue, have the ability to differentiate into various specific cell types including tenocytes. In this retrospective study, clinical data are presented from 83 horses with 176 suspensory ligament injuries, treated with ADRCs, given a strictly enforced standardized rehabilitation program, and followed up for at least one year after returning to work. Assessment for a successful outcome was return to full work (RFW) at a previous or higher level of performance for one year or more without re-injury. RFW numbers were 84.6% for horses with fore-limb ligament injuries and 82.1% for horses with hind-limb injuries. RFW outcomes were slightly better in cases with proximal suspensory ligament desmitis (86.7%) compared to horses with lesions of the body and branches. The ADRC injection procedure was well tolerated; no treatment-related adverse events, including injection flares, were detected in any of the 83 horses. The demonstrated long term stability of healed lesions strongly supports the therapeutic use of regenerative cells extracted from adipose tissue for treatment of acute and chronic, fore- and hind-limb suspensory ligament injuries in horses of various athletic sport disciplines.

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Rich, F. (2014) Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells. Stem Cell Discovery, 4, 44-53. doi: 10.4236/scd.2014.42005.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Smith, R.K.W. (2005) Physiology of Tendon and Ligament. In: Chuit, P. and Montavon, S., Eds., 9th Congress on Equine Medicine & Surgery, International Veterinary Information Service, Geneva, 1903-1905.
[2] Hewes, C.A. and White, N.A. (2006) Outcome of Desmoplasty and Fasciotomy for Desmitis Involving the Origin of the Suspensory Ligament in Horses: 27 Cases (1995-2004). Journal of the American Veterinary Medical Association, 229, 407-412. http://dx.doi.org/10.2460/javma.229.3.407
[3] Dyson, S.J. and Genovese, R.L. (2003) The Suspensory Apparatus. In: Ross, M. and Dyson, S., Eds., Diagnosis and Management of Lameness in the Horse, Saunders, St. Louis, 654-666.
http://dx.doi.org/10.1016/B978-0-7216-8342-3.50080-2
[4] Ross, M.W. (2006) Suspensory Desmitis—Management Options.
[5] Cowles, R.R. (2000) Proximal Suspensory Desmitis—A Qualitative Survey. Proceedings of the Annual Convention—American Association of Equine Practitioners, 46, 143-144.
[6] Dyson, S. (2000) Proximal Suspensory Desmitis in the Forelimb and the Hindlimb. Proceedings of the Annual Convention—American Association of Equine Practitioners, 46, 137-142.
[7] Dahlgren, L. (2005) Review of Treatment Options for Equine Tendon and Ligament Injuries: What’s New and How do They Work? Proceedings of the Annual Convention—American Association of Equine Practitioners.
[8] Textor, J. (2011) Autologous Biologic Treatment for Equine Musculoskeletal Injuries: Platelet-Rich Plasma and IL-1 Receptor Antagonist Protein. Veterinary Clinics of North America: Equine Practice, 27, 275-298. http://dx.doi.org/10.1016/j.cveq.2011.05.001
[9] Bosch G., Moleman M., Barneveld A., van Weeren P.R. and van Schie H.T.M. (2011) The Effect of Platelet-Rich Plasma on the Neovascularization of Surgically Created Equine Superficial Digital Flexor Tendon Lesions. Scandinavian Journal of Medicine & Science in Sports, 21, 554-561.
http://dx.doi.org/10.1111/j.1600-0838.2009.01070.x
[10] Zuk, P.A., Zhu, M. and Ashjian, P. (2002) Human Adipose Tissue Is a Source of Multipotent Stem Cells. Molecular Biology of the Cell, 13, 4279-4295. http://dx.doi.org/10.1091/mbc.E02-02-0105
[11] Park, A., Hogan, M., Kesturu, G., et al. (2010) Adipose-Derived Mesenchymal Stem Cells Treated with Growth Differentiation Factor-5 Expresstendon-Specific Markers. Tissue Engineering, 16, 2941-2951.
[12] Uysal, A.C. and Mizuno, H. (2010) Tendon Regeneration and Repair with Adipose Derived Stem Cells. Current Stem Cell Research & Therapy, 5,161-167. http://dx.doi.org/10.2174/157488810791268609
[13] Nixon, A.J., Dahlgren, L.A., Haupt, et al. (2008) Effect of Adipose Derived Nucleated Cell Fractions on Tendon Repair in Horse with Collagenase-Induced Tendinitis. American Journal of Veterinary Research, 69, 928-937.
[14] Boening, K.J., Loffeld, S., Weitkamp, K. and Matuschek, S. (2000) Radial Extracorporeal Shock Wave Therapy for Chronic Insertion Desmopathy of the Proximal Suspensory Ligament. Proceedings of the Annual Convention—American Association of Equine Practitioners, 46, 203-207.
[15] Crowe, O., Dyson, S.J., Wright, I.M., et al. (2002) Treatment of 45 Cases of Chronic Hindlimb Proximal Suspensory Desmitis by Radial Extracorporeal Shockwave Therapy. Proceedings of the Annual Convention—American Association of Equine Practitioners, 48, 322-325.
[16] Herthel, D.J. (2001) Enhanced Suspensory Ligament Healing in 100 Horses by Stem Cells and Other Bone Marrow Components. Proceedings of the Annual Convention—American Association of Equine Practitioners, 47, 319-321.
[17] Ferris, D.J., Kisiday, J.D., McIlwraith, C.W., et al. (2009) Clinical Follow-Up of Horses Treated with Bone Marrow-Derived Mesenchymal Stem Cells for Musculoskeletal Lesions. Proceedings of the Annual Convention—American Association of Equine Practitioners, 55, 59-60.
[18] Harman, R.J., Cowles, B.C., Orava, J.C. and Harman, S.P. (2007). A Retrospective Review of 52 Cases of Suspensory Ligament Injury in Sport Horses Treated with Adipose-Derived Stem and Regenerative Cell Therapy. Proceedings of Veterinary Orthopedic Society, 34, 28.
[19] Waselau, M., Sutter, W, Genovese, R. and Bertone, A. (2008) Intralesional Injection of Platelet-Rich Plasma Followed by Controlled Exercise for Treatment of Midbody Suspensory Ligament Desmitis in Standardbred Racehorses. Journal of the American Veterinary Medical Association, 232, 1515-1520. http://dx.doi.org/10.2460/javma.232.10.1515
[20] Garrett, K.S., Bramlage, L.R, Spike-Pierce, D.L. and Cohen, N.D. (2013) Injection of Platelet- and Leukocyte-Rich Plasma at the Junction of the Proximal Sesamoid Bone and the Suspensoryligament Branch for Treatment of Yearling Thoroughbreds with Proximal Sesamoid Bone Inflammation and Associated Suspensory Ligament Branch Desmitis. Journal of the American Veterinary Medical Association, 243, 120-125. http://dx.doi.org/10.2460/javma.243.1.120
[21] Vidal, M., Kilroy, G., Lopez, M., et al. (2007) Characterization of Equine Adipose Tissue-Derived Stromal Cells: Adipogenic and Osteogeniccapacity and Comparison with One Marrow-Derived Mesenchymal Stromal Cells. Veterinary Surgery, 36, 613-622. http://dx.doi.org/10.1111/j.1532-950X. 2007.00313.x
[22] Bochev, I., Elmadjian, G., Kyurkchiev, D., et al. (2008) Mesenchymal Stem Cells from Human Bone Marrow or Adiposetissue Differently Modulate Mitogen-Stimulated B-Cellimmunoglobulin Production in Vitro. Cell Biology International, 32, 384-393. http://dx.doi.org/10.1016/j.cellbi.2007.12.007
[23] Tholpady, S.S., Ogle, R.C. and Katz, A.J. (2009) Adipose Stem Cells and Solid Organ Transplantation. Current Opinion in Organ Transplantation, 14, 51-55. http://dx.doi.org/10.1097/MOT.0b013e3283 20d2cf
[24] Melief, S.M., Zwaginga, J.J., Fibbe, W.E. and Roelofs, H. (2013) Adipose-Derived Multipotent Stromal Cells Have a Higher Immunomodulatory Capacity Than Their Bone Marrow Counterparts. Stem Cells Translational Medicine, 2, 455-463. http://dx.doi.org/10.5966/sctm.2012-0184
[25] Caplan, A. (2006) Mesenchymal Stem Cells as Trophic Mediators. Journal of Cellular Biochemistry, 98, 1076-1084. http://dx.doi.org/10.1002/jcb.20886
[26] Hosaka, Y. Teraoka, H., Yamamoto, E., et al. (2005) Mechanism of Cell Death in Inflamed Superficial Digital Flexor Tendon in the Horse. Journal of Comparative Pathology, 132, 51-58.
http://dx.doi.org/10.1016/j.jcpa.2004.06.006

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