Global Stem Cell Technology, ANACURA Group , Evergem , Belgium ; Equine Veterinary Pratice Dr. Suls , Nederweert , Netherlands.
Global Stem Cell Technology, ANACURA Group , Evergem , Belgium.
Front Vet Sci. 2015 Oct 22;2:49. doi: 10.3389/fvets.2015.00049. eCollection 2015.
Suspensory ligament injuries are a common injury in sport horses, especially in competing dressage horses. Because of the poor healing of chronic recalcitrant tendon injuries, this represents a major problem in the rehabilitation of sport horses and often compromises the return to the initial performance level. Stem cells are considered as a novel treatment for different pathologies in horses and humans. Autologous mesenchymal stem cells (MSCs) are well known for their use in the treatment of tendinopathies; however, recent studies report a safe use of allogeneic MSCs for different orthopedic applications in horses. Moreover, it has been reported that pre-differentiation of MSCs prior to injection might result in improved clinical outcomes. For all these reasons, the present case report describes the use of allogeneic tenogenically induced peripheral blood-derived MSCs for the treatment of a proximal suspensory ligament injury. During conservative management for 4 months, the horse demonstrated no improvement of a right front lameness with a Grade 2/5 on the American Association of Equine Practitioners (AAEP) scale and a clear hypo-echoic area detectable in 30% of the cross sectional area. From 4 weeks after treatment, the lameness reduced to an AAEP Grade 1/5 and a clear filling of the lesion could be noticed on ultrasound. At 12 weeks (T 4) after the first injection, a second intralesional injection with allogeneic tenogenically induced MSCs and platelet-rich plasma was given and at 4 weeks after the second injection (T 5), the horse trotted sound under all circumstances with a close to total fiber alignment. The horse went back to previous performance level at 32 weeks after the first regenerative therapy and is currently still doing so (i.e., 20 weeks later or 1 year after the first stem cell treatment). In conclusion, the present case report demonstrated a positive evolution of proximal suspensory ligament desmitis after treatment with allogeneic tenogenically induced MSCs.
悬韧带损伤是运动马的常见损伤，尤其是在竞技盛装舞步马中。由于慢性难治性肌腱损伤的愈合不良，这是运动马康复的一个主要问题，往往会影响其恢复到初始运动水平。干细胞被认为是治疗马和人类不同疾病的一种新方法。自体间充质干细胞（MSCs）因其在治疗腱病中的应用而广为人知；然而，最近的研究报告称，同种异体 MSCs 可安全用于马的不同骨科应用。此外，据报道，注射前对 MSCs 进行预分化可能会导致临床结果的改善。基于所有这些原因，本病例报告描述了使用同种异体、具有腱诱导能力的外周血源性 MSCs 治疗近端悬韧带损伤。在保守治疗 4 个月期间，这匹马的右前肢跛行没有改善，美国兽医协会（AAEP）评分为 2/5，在横截面的 30%处可检测到明显的低回声区。从治疗后 4 周开始，跛行程度降至 AAEP 评分为 1/5，超声检查可明显发现病变填充。第一次注射后 12 周（T4），进行了第二次同种异体、具有腱诱导能力的 MSC 和富含血小板的血浆的病灶内注射，第二次注射后 4 周（T5），这匹马在所有情况下都能稳健地奔跑，纤维排列几乎完全正常。在第一次再生治疗后 32 周，这匹马恢复到之前的运动水平，目前仍保持如此（即，在第一次干细胞治疗后 20 周或 1 年后）。总之，本病例报告显示，同种异体、具有腱诱导能力的 MSCs 治疗后，近端悬韧带腱炎有积极的演变。
