Department of Veterinary Science, University of Parma, 43126 Parma, Italy.
Int J Immunopathol Pharmacol. 2013 Jan-Mar;26(1 Suppl):61-8. doi: 10.1177/03946320130260s108.
Overstrain tendonitis are common pathologies in the sport horses. Therapeutic approaches to tendon healing do not always result in a satisfactory anatomical and functional repair, and healed tendon is often characterized by functional impairment and high risk of reinjury. Recently, mesenchymal stem cells (MSCs) and platelet rich plasma (PRP) have been proposed as novel therapeutic treatments to improve the tendon repair process. MSCs are multipotent, easy to culture and being originated from adult donors do not pose ethical issues. To date, autologous MSCs have been investigated mainly in the treatment of large bone defects, cardiovascular diseases, osteogenesis imperfecta and orthopaedic injuries both in human and veterinary medicine. The clinical applications in which autologous MSCs can be used are limited because patient-specific tissue collection and cell expansion require time. For clinical applications in which MSCs should be used right away, it would be more practical to use cells collected from a donor, expanded in vitro and banked to be readily available when needed. However, there are concerns over the safety and the efficacy of allogeneic MSCs. The safety and efficacy of a therapy based on the use of allogeneic adipose tissue-derived mesenchymal stem cells (ASCs) associated to platelet rich plasma (PRP) were evaluated in 19 horses affected by acute or subacute overstrain superficial digital flexor tendonitis (SDFT). The application of allogeneic ASCs neither raised clinical sign of acute or chronic adverse tissue reactions, nor the formation of abnormal tissue in the long-term. After a follow-up of 24 months, 89.5% horses returned to their previous level of competition, while the reinjury rate was 10.5%, comparable to those recently reported for SDFT treated with autologous bone marrow derived MSCs. This study suggests that the association between allogeneic ASCs and PRP can be considered a safe and effective strategy for the treatment of SDF tendonitis in the horse.
过度使用肌腱炎是运动马的常见病理。治疗肌腱愈合的方法并不总是导致令人满意的解剖和功能修复，而愈合的肌腱通常表现为功能障碍和高再损伤风险。最近，间充质干细胞（MSCs）和富含血小板的血浆（PRP）已被提议作为改善肌腱修复过程的新的治疗方法。MSCs 是多能的，易于培养，并且源自成人供体，不会带来伦理问题。迄今为止，自体 MSCs 主要在治疗大骨缺损、心血管疾病、成骨不全症和骨科损伤方面在人类和兽医医学中进行了研究。由于需要患者特异性组织采集和细胞扩增，自体 MSCs 的临床应用受到限制。对于需要立即使用 MSCs 的临床应用，使用从供体采集、体外扩增并储存以备需要时随时使用的细胞会更加实用。然而，异体 MSCs 的安全性和有效性存在担忧。在 19 匹患有急性或亚急性过度使用浅表屈肌腱炎（SDFT）的马中，评估了基于使用富含血小板的血浆（PRP）的同种异体脂肪组织来源的间充质干细胞（ASCs）的治疗的安全性和有效性。同种异体 ASCs 的应用既没有引起急性或慢性组织不良反应的临床迹象，也没有在长期内形成异常组织。随访 24 个月后，89.5%的马恢复到以前的比赛水平，而再损伤率为 10.5%，与最近报道的自体骨髓来源 MSCs 治疗 SDFT 的再损伤率相当。这项研究表明，同种异体 ASCs 与 PRP 的联合应用可以被认为是治疗马 SDF 肌腱炎的一种安全有效的策略。
