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Pérez Fraile A, González-Cubero E, Martínez-Flórez S, Olivera ER, Villar-Suárez V. Regenerative Medicine Applied to Musculoskeletal Diseases in Equines: A Systematic Review. Vet Sci 2023; 10:666. [PMID: 38133217 PMCID: PMC10748126 DOI: 10.3390/vetsci10120666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
Musculoskeletal injuries in horses have a great economic impact, predominantly affecting tendons, ligaments, and cartilage, which have limited natural regeneration. Cell therapy, which uses mesenchymal stem cells due to their tissue differentiation properties and anti-inflammatory and immunoregulatory effects, aims to restore damaged tissue. In this manuscript, we performed a systematic review using the Parsifal tool, searching the PubMed and Web of Science databases for articles on regenerative medicine for equine musculoskeletal injuries. Our review covers 17 experimental clinical studies categorized by the therapeutic approach used: platelet-rich plasma, conditioned autologous serum, mesenchymal stem cells, and secretome. These therapies reduce healing time, promote regeneration of fibrocartilaginous tissue, improve cellular organization, and improve joint functionality and sustainability. In conclusion, regenerative therapies using platelet-rich plasma, conditioned autologous serum, equine mesenchymal stem cells, and the emerging field of the secretome represent a promising and highly effective approach for the treatment of joint pathologies in horses, implying a valuable advance in equine healthcare.
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Affiliation(s)
- Andrea Pérez Fraile
- Department of Anatomy, Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
| | - Elsa González-Cubero
- Department of Anatomy, Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
| | - Susana Martínez-Flórez
- Department of Anatomy, Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
- Institute of Biomedicine (IBIOMED), Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
| | - Elías R. Olivera
- Department of Molecular Biology, Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
| | - Vega Villar-Suárez
- Department of Anatomy, Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
- Institute of Biomedicine (IBIOMED), Veterinary Faculty, Campus de Vegazana, Universidad de León, 24007 León, Spain
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Broeckx SY, Pille F, Buntinx S, Van Brantegem L, Duchateau L, Oosterlinck M, Chiers K, Bertone AL, Spaas JH, Martens AM. Evaluation of an osteochondral fragment-groove procedure for induction of metacarpophalangeal joint osteoarthritis in horses. Am J Vet Res 2019; 80:246-258. [PMID: 30801207 DOI: 10.2460/ajvr.80.3.246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate lameness and morphological changes associated with an osteochondral fragment-groove procedure as a means of experimental induction of metacarpophalangeal (MCP) joint osteoarthritis within an 11-week period in horses. ANIMALS 6 nonlame adult warmbloods. PROCEDURES The right MCP joint of each horse underwent an osteochondral fragment-groove procedure (day 0). After 1 week of stall rest (ie, starting day 7), each horse was trained daily on a treadmill. Weekly, horses underwent visual and inertial sensor-based assessments of lameness. Both MCP joints were assessed radiographically on days 0 (before surgery), 1, 35, and 77. A synovial fluid sample was collected from the right MCP joint on days 0 (before surgery), 35, 36, 49, 63, and 77 for cytologic and biomarker analyses. On day 77, each horse was euthanized; both MCP joints were evaluated macroscopically and histologically. RESULTS Right forelimb lameness was detected visually and by the inertial sensor system when horses were moving on a straight line after distal forelimb flexion or circling left on days 14 to 77. Compared with presurgical values, synovial fluid interleukin-6, prostaglandin E2, hyaluronic acid, and interleukin-1 receptor antagonist protein concentrations were increased at 2 or 3 time points, whereas tumor necrosis factor-α and interleukin-10 concentrations were decreased at 1 time point. Gross examination of all right MCP joints revealed synovitis and wear lines; synovitis was confirmed histologically. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a combined osteochondral fragment-groove procedure can be used to induce clinically and grossly observable early MCP joint osteoarthritis during an 11-week period in horses.
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Broeckx SY, Seys B, Suls M, Vandenberghe A, Mariën T, Adriaensen E, Declercq J, Van Hecke L, Braun G, Hellmann K, Spaas JH. Equine Allogeneic Chondrogenic Induced Mesenchymal Stem Cells Are an Effective Treatment for Degenerative Joint Disease in Horses. Stem Cells Dev 2019; 28:410-422. [PMID: 30623737 PMCID: PMC6441287 DOI: 10.1089/scd.2018.0061] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Degenerative joint disease is one of the main causes of equine early retirement from pleasure riding or a performance career. The disease is initially triggered by an abnormal loading of normal cartilage or a normal loading of abnormal cartilage. This primary insult is accompanied with joint inflammation, which leads to further progressive degeneration of the articular cartilage and changes in the surrounding tissues. Therefore, in search for an effective treatment, 75 adult horses with early signs of degenerative fetlock joint disease were enrolled in a randomized, multicenter, double-blinded, and placebo-controlled study. Fifty animals were injected intra-articularly with the investigational veterinary product (IVP) consisting of allogeneic chondrogenic induced mesenchymal stem cells (ciMSCs) with equine allogeneic plasma, and 25 horses were injected with 0.9% NaCl (saline) control product. From week 3 to 18 after treatment, lameness scores (P < 0.001), flexion test responses (P < 0.034), and joint effusion scores (P < 0.001) were remarkably superior in IVP-treated horses. Besides nasal discharge in both treatment groups, no adverse events were observed during the entire study period. On long-term follow-up (1 year), significantly more investigational product-treated horses were working at training level or were returned to their previous level of work (P < 0.001).
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Affiliation(s)
- Sarah Y Broeckx
- 1 Global Stem cell Technology NV, Anacura Group, Evergem, Belgium
| | - Bert Seys
- 2 Equine Veterinary Practice Dr Suls, SP Weert, the Netherlands
| | - Marc Suls
- 2 Equine Veterinary Practice Dr Suls, SP Weert, the Netherlands
| | | | - Tom Mariën
- 4 Equitom Equine Hospital, Meldert, Belgium
| | - Edouard Adriaensen
- 3 Equine Veterinary Service Adriaensen-Vandenberghe, Waasmunster, Belgium.,4 Equitom Equine Hospital, Meldert, Belgium
| | | | - Lore Van Hecke
- 1 Global Stem cell Technology NV, Anacura Group, Evergem, Belgium
| | | | | | - Jan H Spaas
- 1 Global Stem cell Technology NV, Anacura Group, Evergem, Belgium
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Broeckx S, Spaas J, Chiers K, Duchateau L, Van Hecke L, Van Brantegem L, Dumoulin M, Martens A, Pille F. Equine allogeneic chondrogenic induced mesenchymal stem cells: A GCP target animal safety and biodistribution study. Res Vet Sci 2018; 117:246-254. [DOI: 10.1016/j.rvsc.2017.12.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/18/2017] [Accepted: 12/26/2017] [Indexed: 12/17/2022]
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Bembo F, Eraud J, Philandrianos C, Bertrand B, Silvestre A, Veran J, Sabatier F, Magalon G, Magalon J. Combined use of platelet rich plasma & micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses. Muscles Ligaments Tendons J 2016; 6:198-204. [PMID: 27900293 PMCID: PMC5115251 DOI: 10.11138/mltj/2016.6.2.198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To assess the safety and potential efficacy of a standardized technique consisting of intra-articular injection of 10 cc of a homogeneous mixed product using autologous micro-fat and platelet rich plasma (PRP) (ratio 1:1) in the carpus or the fetlock joint of sport horses presenting degenerative joint disease (DJD). METHODS Eight sport horses with DJD confirmed by radiography and ultrasonography and causing lameness and the impossibility to compete were treated. PRP was prepared after a double centrifugation whereas micro-fat was harvested and purified using a closed system. The two products were connected and mixed by gentle back and forth shaking of the syringes to finally obtain 10 ml of an homogeneous mixed product. Follow up was performed from 5 to 10 months with assessment of AAEP lameness score and return to training and competition. RESULTS Nine joints were treated with significant improvement of the AAEP lameness score three months after the procedure (p = 0.021). Four horses returned to official competition between 5 to 10 months after the procedure (7.0±2.5) and three of them resumed intensive training between 5 to 9 months (6.3±2.3). No adverse event occurred. CONCLUSION This study is a first step in the development of innovative therapy for DJD which combines the potential chondrogenic differentiation of MSCs inside equine adipose tissue with the proliferative effect of growth factors present in PRP.
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Affiliation(s)
| | - Julia Eraud
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Cecile Philandrianos
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Baptiste Bertrand
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Alain Silvestre
- Radiology Department, Bordeaux Merignac Sports Clinic, Merignac, France
| | - Julie Veran
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - Florence Sabatier
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
| | - Guy Magalon
- Plastic Surgery Department, La Conception University Hospital, Marseille, France
| | - Jeremy Magalon
- Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, La Conception University Hospital, Marseille, France
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Regenerative therapies for equine degenerative joint disease: a preliminary study. PLoS One 2014; 9:e85917. [PMID: 24465787 PMCID: PMC3896436 DOI: 10.1371/journal.pone.0085917] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 12/09/2013] [Indexed: 12/13/2022] Open
Abstract
Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment.
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Expression of purinergic P2X receptor subtypes 1, 2, 3 and 7 in equine laminitis. Vet J 2013; 198:472-8. [PMID: 24080476 DOI: 10.1016/j.tvjl.2013.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/09/2013] [Accepted: 08/12/2013] [Indexed: 12/13/2022]
Abstract
Tissue sensitisation and chronic pain have been described in chronic-active laminitis in the horse, making treatment of such cases difficult. Purinergic P2X receptors are linked to chronic pain and inflammation. The aim of this study was to examine the expression of purinergic P2X receptor subtypes 1, 2, 3 and 7 in the hoof, palmar digital vessels and nerve, dorsal root ganglia and spinal cord in horses with chronic-active laminitis (n=5) compared to non-laminitic horses (n=5). Immunohistochemical analysis was performed on tissue sections using antibodies against P2X receptor subtypes 1-3 and 7. In horses with laminitis, there was a reduction in the thickness of the tunica media layer of the palmar digital vein as a proportion of the whole vessel diameter (0.48±0.05) compared to the non-laminitic group (0.57±0.04; P=0.02). P2X receptor subtype 3 was expressed in the smooth muscle layer (tunica media) of the palmar digital artery of horses with laminitis, but was absent in horses without laminitis. There was strong expression of P2X receptor subtype 7 in the proliferating, partially keratinised, epidermal cells of the secondary epidermal lamellae in the hooves of horses with laminitis, but no immunopositivity in horses without laminitis.
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Hoffman C, Clark C. Prognosis for Racing with Conservative Management of Cervical Vertebral Malformation in Thoroughbreds: 103 Cases (2002-2010). J Vet Intern Med 2013; 27:317-23. [DOI: 10.1111/jvim.12053] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 09/19/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022] Open
Affiliation(s)
- C.J. Hoffman
- Marion DuPont Scott Equine Medical Center; Virginia/Maryland Regional College of Veterinary Medicine Leesburg VA
| | - C.K. Clark
- Peterson and Smith Equine Hospital; Ocala FL
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IRELAND JL, CLEGG PD, McGOWAN CM, McKANE SA, CHANDLER KJ, PINCHBECK GL. Disease prevalence in geriatric horses in the United Kingdom: Veterinary clinical assessment of 200 cases. Equine Vet J 2011; 44:101-6. [DOI: 10.1111/j.2042-3306.2010.00361.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Koene M, Goupil X, Kampmann C, Hanson PD, Denton D, Pollmeier MG. Field Trial Validation of the Efficacy and Acceptability of Firocoxib, a Highly Selective Cox-2 Inhibitor, in a Group of 96 Lame Horses. J Equine Vet Sci 2010. [DOI: 10.1016/j.jevs.2010.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Brown PA, Bodles-Brakhop A, Draghia-Akli R. Plasmid growth hormone releasing hormone therapy in healthy and laminitis-afflicted horses-evaluation and pilot study. J Gene Med 2008; 10:564-74. [PMID: 18302303 DOI: 10.1002/jgm.1170] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND In vivo electroporation dramatically improves the potency of plasmid-mediated therapies, including in large animal models. Laminitis and arthritis are common and debilitating diseases in the horse, as well as humans. METHODS The effects of growth hormone releasing hormone (GHRH) on healthy horses and on horses with laminitis that were followed for 6 months after a single intramuscular injection and electroporation of 2.5 mg of an optimized myogenic GHRH-expressing plasmid were examined. RESULTS In the first study on six healthy horses, we observed a significant increase in body mass by day 180 compared to baseline (P < 0.003), and an increase in erythrocyte production (hematocrit, red blood cells, hemoglobin, P = 0.03). IGF-I levels were increased by 7% by day 120 (P = 0.02). A pilot study was performed on two horses with chronic laminitis, a vascular condition often associated with arthritis, with two horses with similar clinical disease serving as non-treated controls. Treated horses experienced an increase in weight compared to control horses that received standard care (P = 0.007). By 6 months post-treatment, treated subjects were rated pasture sound. Physical and radiographic evaluation demonstrated significant improvement with reduced inflammation and decreased lameness. CONCLUSIONS These results demonstrate that a plasmid therapy delivered by electroporation can potentially be used to treat chronic conditions in horses, and possibly other very large mammals. While further studies are needed, overall this proof-of-concept work presents encouraging data for studying gene therapeutic treatments for Raynaud's syndrome and arthritis in humans.
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Abstract
In horses, lameness is often attributable to some degree of osteoarthritis (OA), a complex disease process that is highlighted by eventual degradation of articular cartilage. Conventional therapies for OA in horses are designed to relieve pain and discomfort and often include pharmacologic intervention with nonsteroidal anti-inflammatory drugs or intra-articular steroids. Oral administration of nutraceutical products to the horse is common and easy and is perceived to be a benign treatment for OA in horses. The main goal for use of nutraceuticals is to use them in OA cases to attempt to lower the dose of other drugs that are more problematic while potentially preventing further degradation (disease or structure modifying). This article attempts to define a nutraceutical, identifies areas that need to be considered when these products are used, and describes the known scientific effects of the most common compounds contained in currently available equine nutraceuticals.
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Affiliation(s)
- Troy N Trumble
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, PO Box 100136, Gainesville, FL 32610, USA.
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Neil KM, Caron JP, Orth MW. The role of glucosamine and chondroitin sulfate in treatment for and prevention of osteoarthritis in animals. J Am Vet Med Assoc 2005; 226:1079-88. [PMID: 15825732 DOI: 10.2460/javma.2005.226.1079] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Kirsten M Neil
- Department of Large Animal Clinical Science, College of Veterinary Medicine, Michigan State University, East Lansing, Ml 48824-1314, USA
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