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THE USE OF STEM CELLS AS A REGENERATIVE THERAPY FOR CHRONIC LAMINITIS
Nikki Engwall
Penn State University
Overview- Laminitis
Caused by: Endocrinatic diseases Systemic infections Non-weight bearing lameness
Symptoms include lameness, heat in affected foot, reluctance to walk, change in stance, change in hoof shape
Distal Phalanx Displacement Inflammation damages laminar
attachments, causing distal phalanx to displace
Scar tissue sometimes forms between displaced coffin bone and hoof wall, called the laminar wedge, measured by hoof laminar zone (HLZ)
Types of displacement Rotation Sinking
Common Treatments
NSAIDS and analgesics Corrective padding and shoeing Dorsal wall resection Deep digital flexor tenotomy
Regardless of treatment, success rates are low with chronic laminitis cases
Regenerative Therapy
Use of pluripotent mesenchymal stem cells (MSC) to repair musculoskeletal tissue
Harvested from horse’s blood, bone marrow, or fat cells
Inhibit scar formation and cell death, increase blood flow, stimulate growth of new cells, release growth factors and anti-inflammatory proteins
Use in Treating Laminitis
Study at Rood and Riddle Equine Hospital in Kentucky tested MSC treatment in 30 horses, age 2-20 diagnosed with chronic laminitis Six classified as severe rotation with
moderate bone disease, six with rotation and severe bone disease, and 18 as sinking
Each received 20-30 million MSC in each affected foot in one month intervals
Average 3-4 treatments per horse
Results of Study
Treatment found to be successful if horse was pasture sound without maintenance or heavy medication for one year 21 of the 30 cases were successful (70%) 15 of the 18 sinkers were successful (83%)
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci. Oct 2013)
Results continued
The sooner the horse received treatment, the better Median time to first treatment was 71.5 days
13 of the 15 horses treated before 71.5 days were successful (87%)
8 of the 15 treated later were successful (53%)
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci. Oct 2013)
Results continued
Growth of laminar wedge has negative effect Scar tissue generally forms around 90 days 11 of the 16 horses first treated before 90 days
had improved HLZ (69%) 2 of the 12 horses treated after formation of the
laminar wedge showed improved HLZ (17%) Similar to earlier study published in 2011 In
JEVS, 83% found successful using allogenic MSCs
(Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci. Oct 2013)
Future applications
Questions still remain How should the stem cells be given for optimum
results? Where is the best place to give stem cells? What is the best kind of stem cells to use?
Lack of information on long term effects Safety concerns and possible interactions
with other biological molecules.
In Conclusion…
Stem cell therapy has been known to be successful in treating various orthopedic injuries, but only recently has been studied in treating laminitis
Recent work has shown positive results in treating laminitis
Early intervention is key
References
Dryden, Vernon C et al. Using stem cells in clinical cases. Journal Equine Veterinary Sci. Oct 2013
Morrison, Scott. Successful use of allogenic umbilical cord-derived stem cells in nonresponsive chronic laminitic cases. Journal Equine Veterinary Sci. Oct 2011
Schnabel, Lauren V et al. Therapeutic use of stem cells in horses: Which type, how, and when?. The Veterinary Journal. Sept 2013
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