Armitage Andrew J, Miller Joanna M, Sparks Tim H, Georgiou Alex E, Reid Jacqueline
Greenside Veterinary Practice, Part of Linnaeus Veterinary Limited, Melrose, United Kingdom.
Cell Therapy Sciences Ltd., Coventry, United Kingdom.
Front Vet Sci. 2023 Jan 13;9:1014687. doi: 10.3389/fvets.2022.1014687. eCollection 2022.
The objective of this study was to retrospectively analyze clinical data from a referral regenerative medicine practice, to investigate the efficacy of autologous mesenchymal stromal cells (MSC) in 245 dogs deemed unresponsive to conventional treatment by their referring vet.
Diagnostic imaging [radiology and musculoskeletal ultrasound (MSK-US)] identified musculoskeletal pathology holistically. MSCs, produced according to current guidelines, were initially administered with PRP by targeted injection to joints and/or tendons, with a second MSC monotherapy administered 12 weeks later to dogs with severe pathology and/or previous elbow arthroscopic interventions. Dogs with lumbosacral disease received epidural MSCs with additional intravenous MSCs administered to dogs with spondylosis of the cervical, thoracic and lumbar spine. All dogs received laser therapy at 10 J/cm at the time of treatment and for 5 sessions thereafter. Objective outcome measures (stance analysis, range of joint motion, pressure algometry) and validated subjective outcome measures (owner reported VetMetrica HRQL™ and veterinary pain and quality of life impact scores) were used to investigate short and long-term (6-104 weeks) efficacy. Outcome data were collected at predetermined time windows (0-6, 7-12, 13-18, 19-24, 25-48, 49-78, 79-104) weeks after initial treatment.
There were statistically significant improvements in post compared with pre-treatment measures at all time windows in stance analysis, shoulder and hip range of motion, lumbosacral pressure algometry, and to 49-78 weeks in carpus and elbow range of motion. Improvements in 4 domains of quality of life as measured by VetMetricaTM were statistically significant, as were scores in vet-assessed pain and quality of life impact. In dogs receiving one initial treatment the mean time before a second treatment was required to maintain improvements in objective measures was 451 days. Diagnostic imaging confirmed the regenerative effects of MSCs in tendinopathies by demonstrating resolution of abnormal mineralization and restoration of normal fiber patterns.
This represents the first study using "real-world" data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years.
本研究的目的是回顾性分析一家再生医学转诊机构的临床数据，以调查自体间充质基质细胞（MSC）对245只被转诊兽医认为对传统治疗无反应的犬的疗效。
诊断成像[放射学和肌肉骨骼超声（MSK-US）]全面识别肌肉骨骼病变。按照当前指南生产的MSC最初与PRP一起通过靶向注射到关节和/或肌腱，12周后对患有严重病变和/或先前接受过肘部关节镜干预的犬进行第二次MSC单一疗法治疗。患有腰骶部疾病的犬接受硬膜外MSC治疗，颈椎、胸椎和腰椎脊柱病的犬额外接受静脉注射MSC治疗。所有犬在治疗时接受10 J/cm的激光治疗，并在之后进行5次治疗。使用客观结局指标（姿态分析、关节活动范围、压力痛觉测定）和经过验证的主观结局指标（主人报告的VetMetrica HRQL™以及兽医疼痛和生活质量影响评分）来研究短期和长期（6-104周）疗效。在初始治疗后的预定时间窗口（0-6、7-12、13-18、19-24、25-48、49-78、79-104周）收集结局数据。
在姿态分析、肩部和髋部活动范围、腰骶部压力痛觉测定方面，与治疗前相比，所有时间窗口的治疗后均有统计学显著改善，腕关节和肘关节活动范围在49-78周时也有改善。通过VetMetricaTM测量的生活质量4个领域的改善具有统计学显著性，兽医评估的疼痛和生活质量影响评分也有改善。在接受一次初始治疗的犬中，为维持客观指标的改善而需要进行第二次治疗的平均时间为451天。诊断成像通过显示异常矿化的消退和正常纤维模式的恢复，证实了MSC对肌腱病的再生作用。
这是第一项使用“真实世界”数据表明，以靶向整体方法将基于细胞的疗法注射到肌肉骨骼病变的多个区域，对患者的疼痛状态和生活质量产生了快速而显著的积极影响，并且通过重复治疗可维持长达2年。
