Gene Therapy Using Plasmid DNA Encoding Bone Morphogenetic Protein 2 and Vascular Endothelial Growth Factor 164 Genes for the Treatment of Equine Proximal Suspensory Desmitis: Case Reports
Authors: Kovac Milomir, Aliev Ruslan, Berestov Iliya Berestov, Aimaletdinov Alexander, Rutland Catrin, Rizvanov Albert, Zakirova Elena
Summary
# Editorial Summary: Gene Therapy for Equine Proximal Suspensory Desmitis Proximal suspensory desmitis remains one of the most challenging soft-tissue injuries to manage in performance horses, with conventional treatment frequently failing to restore full function—particularly in chronic cases. Researchers administered plasmid DNA encoding equine bone morphogenetic protein 2 and vascular endothelial growth factor 164 directly into damaged proximal suspensory ligament tissue, supporting the intervention with box rest and controlled exercise over a 12-month monitoring period using ultrasonographic assessment and clinical evaluation. Forelimb cases showed notable improvement by day 30 with no adverse reactions, whilst chronic hindlimb injuries demonstrated minimal clinical response, though ultrasound revealed improved echogenicity and fibre alignment despite no measurable changes in ligament cross-sectional dimensions. Tissue regeneration appears dependent on lesion acuity rather than severity alone, suggesting gene therapy may represent a valuable option for acute or subacute proximal suspensory desmitis in forelimbs but warrants further investigation before application to established hindlimb cases. These findings provide preliminary evidence that growth factor gene delivery could expand the therapeutic toolkit for this notoriously difficult condition, though practitioners should consider the anatomical location and injury chronology when evaluating suitability for individual cases.
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Practical Takeaways
- •Gene therapy using BMP2 and VEGF164 may offer a new treatment option for acute/subacute proximal suspensory ligament injuries, particularly in forelimbs, where clinical improvements appear within 30 days
- •This approach appears safer than some existing treatments (no adverse effects reported), but long-term durability and comparison to standard therapies require further investigation
- •Chronic hindlimb PSD cases may not benefit from this intervention, so early intervention in acute cases and careful case selection based on lesion chronicity and location appear critical
Key Findings
- •Gene therapy using plasmid DNA encoding BMP2 and VEGF164 showed clinical improvements by day 30, particularly in forelimb-affected horses
- •Ultrasound imaging demonstrated improved echogenicity and fiber alignment scoring in treated ligaments
- •No negative side effects were observed during the 12-month follow-up period
- •Chronic hindlimb PSD cases showed minimal clinical improvement despite gene therapy, suggesting lesion chronicity and location affect treatment efficacy