Accelerating Medical Progress on Equine Lameness

Substantial progress has been made over the last several decades in both lameness diagnosis and treatment, and science and technology are continuing to drive advances in clinical disciplines.

Photo: Stephanie L. Church, Editor-in-Chief

In the horse world, lameness is a major problem. On this point, everyone agrees. Whether your focus is elite equine athletes or pleasure horses, whether you are a professional or a recreational rider, whether your primary breed of interest is large or small, musculoskeletal injuries are common and potentially very serious.

Substantial progress has been made over the last several decades in both lameness diagnosis and treatment. Importantly, the future holds as much promise as ever. Science and technology are continuing to drive advances in clinical disciplines.

Cell biology is a good example. With next generation sequencing applied on a genomic scale (inclusive of all DNA or all RNA), it is now possible to broadly compare gene expression between individual tissues and cell types. Data-driven scientific approaches are discovering a large number of genes that nobody realized were important. The results are providing new insights into cellular identity, normal function, and disease mechanisms in areas that have direct relevance to lameness.

New understanding about individual cell types enables diagnostic and therapeutic strategies to be refined. Consider cartilage as an example. Our bodies contain several different cartilaginous tissues—joint (articular) cartilage, non-articular structural cartilage, cartilage that is replaced by bone through a process called endochondral ossification, and others. Although all types of cartilage have features in common, an understanding of the unique cellular characteristics that define articular chondrocytes is clearly an important parameter to consider with joint diseases.

Going forward, veterinarians will increasingly have access to molecular biomarker panels to help refine their list of differential diagnoses, to select optimal therapies, and for patient monitoring. We already hear about these approaches with cancer patients, and the same concepts are applicable for bone, cartilage, tendon, ligament, and muscle tissues. The clinical goals include improved sensitivity in monitoring health as well as early identification of disease problems and how the patient is responding to treatment.

On a therapeutic level, cell-based approaches are generating high levels of interest and for good reasons. The term “stem cells” is mentioned frequently. Cells can be used therapeutically to deliver beneficial equine-specific growth and differentiation factors to an area of injury, to modulate the patient’s immune system in helpful ways, and in some cases to directly generate a repair tissue. There is much to learn and quite a bit of misinformation being disseminated, but cell-based therapies do indeed hold a lot of promise.

Finally, we have entered the era of medical informatics. Hardware, software, and data storage options in computer science have advanced rapidly to enable “big data” analyses that resolve biomedical relationships and patterns from “-omic” and population levels that would be very hard to appreciate by looking only at an individual gene or a single patient. By analogy, consider how difficult it would be to resolve crop circles and other patterns in a grain field while standing on the ground. They are much easier to appreciate while looking out the window of an airplane. It is not an “either/or” issue—broad and targeted analyses are both important and often complementary.

So, how can we facilitate further progress in addressing equine lameness challenges? A very important part of the answer is quality scientific research to advance knowledge. At the University of Kentucky (UK), we have established the Equestrian Sports Research Initiative to enable multidisciplinary research teams to work together collaboratively with industry groups, clinical veterinarians, and horse professionals. Health and welfare issues in equine sports medicine are being studied from basic to clinical levels by considering horse, rider, and surface issues concurrently. As noted above, scientific and technological advances are driving progress in biomedical disciplines. Objective scientific research and the resulting new knowledge are absolutely key, and need to be a top priority.

CONTACT: James N. MacLeod, VMD, PhD——859/218-1099—UK Maxwell H. Gluck Equine Research Center, Lexington, Kentucky

This is an excerpt from Equine Disease Quarterly, funded by underwriters at Lloyd’s, London.

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Equine Disease Quarterly

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