Potential Impacts of Regenerative Medicine in Horses

Potential Impacts of Regenerative Medicine in Horses

Photo: The Horse Staff

The use of the stem cell as regenerative medicine therapeutics in the treatment of equine orthopedic injuries has recently received increased attention. Stories of successful "cures" have precipitated a high level of public expectation regarding the efficacy of stem cell therapy in both animals and humans. This expectation has escalated the demand for the use of various regenerative medical products by veterinarians.

While most veterinary scientists and clinicians with experience in regenerative medicine agree that there is ample anecdotal evidence to indicate that stem cell therapy has efficacy in the treatment of equine orthopedic injuries, most would also agree that further basic research and controlled clinical trials are necessary. At the recent North American Veterinary Regenerative Medicine Association Conference, held June 2-4 in Lexington, Ky., scientists and clinicians presented ample evidence for the in vitro (in the laboratory) actions and capabilities of stem cells. Demonstrations of their potential capability for tissue regeneration alone and in combination with various growth factors and/or scaffolding materials were quite impressive. These discussions left no doubt in the minds of presenting researchers and attendees of the future potential for biological medicine.

While scientists are able to accomplish rather amazing feats of tissue repair and/or regeneration under laboratory conditions, they have been able to affect or even control those desired actions within the body for relatively few disease conditions. The best dose regimen and route of administration are questions that have yet to be fully resolved. Controversies exist over how "true stem cells" are identified and counted in animals, which source of cells is best for specific conditions, and which expansion, cryopreservation, and reconstitution techniques are optimal.

Other unanswered questions concern the relative practicality and value added for the clinical application of allogeneic (non-self) over autologous (self-derived) sourced cells. Currently, while autologous cells are most often employed clinically, their use dictates a delay of a few days to a few weeks for cells to be prepared for injection, especially if cell expansion is requested. This extra time often complicates or precludes the treatment of patients with acute injuries.

Since it has been demonstrated that stem cells are not targeted by the body for rejection, the use of pre-prepared and ready-to-use donor cells would seem optimal. In fact, this type of therapy has already been successfully employed in numerous experimental cases. However, several serious scientific and regulatory hurdles need to be overcome before any allogeneic product could be brought to market. These products would be considered drugs by the Food and Drug Administration, so both safety and efficacy trials would first have to be completed. Such trials are expensive and time consuming; therefore, the commercial availability of such products is a long way off.

Regardless of the regulatory and scientific hurdles, the equine industry is beginning to see a myriad of "stem cell" and regenerative medicine products and services brought to market and heavily advertised. While some of these products and services may have legitimate claims to efficacy, others may be questionable. Veterinary practitioners should educate themselves on the basics of stem cell biology and clinical applications so wise therapeutic choices can be made.

CONTACT: Gregory Ferraro, DVM--530/752-6433--glferraro@ucdavis.edu--Director, Center for Equine Health, University of California, Davis, School of Veterinary Medicine, Davis, California

This is an excerpt from Equine Disease Quarterly, funded by underwriters at Lloyd's, London, brokers, and their Kentucky agents.

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