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farriery
veterinary
biomechanics
anatomy
nutrition
physiotherapy
2024
RCT

Equine allogeneic tenogenic primed mesenchymal stem cells: A clinical field study in horses suffering from naturally occurring superficial digital flexor tendon and suspensory ligament injuries.

Authors: Carlier Stephanie, Depuydt Eva, Suls Marc, Bocqué Cedric, Thys Justine, Vandenberghe Aurélie, Martens Ann, Saunders Jimmy, Hellmann Klaus, Braun Gabriele, Beerts Charlotte, Spaas Jan H

Journal: Equine veterinary journal

Summary

# Editorial Summary Tenogenic primed allogeneic mesenchymal stem cells (tpMSCs) derived from peripheral blood represent a promising intervention for the notoriously challenging problem of superficial digital flexor tendon and suspensory ligament injuries in sport horses. This multicentre, randomised, placebo-controlled trial enrolled 100 client-owned horses (66 receiving tpMSC injection, 34 saline control) and assessed both short-term ultrasonographic changes and long-term re-injury rates over two years. At 112 days post-treatment, tpMSC-treated horses demonstrated substantially superior outcomes: 100% versus 54.5% achieved improvement in fibre alignment scoring, 97.0% versus 57.6% showed improved echogenicity, lesion size reduction averaged −27.6 mm² versus −4.6 mm², and 65% versus 9% achieved complete fibre alignment normalisation (FAS = 0). Long-term follow-up data proved particularly striking, with 77% of tpMSC-treated horses (41 of 53) remaining free from re-injury compared to just 8% of control animals (2 of 26). These findings suggest that intralesional tpMSC therapy significantly accelerates tissue remodelling and produces clinically meaningful improvements in structural healing quality, potentially justifying its use as an adjunctive treatment in cases where conventional rehabilitation protocols alone prove insufficient.

Read the full abstract on PubMed

Practical Takeaways

  • Intralesional tenogenic primed allogeneic MSC injection is a safe, evidence-based treatment option for SDFT and suspensory ligament injuries with significantly better healing outcomes and lower re-injury rates than placebo over 2 years
  • Treated horses show objective improvements in tissue quality (fibre alignment and echogenicity) measurable by ultrasound, supporting return to athletic work with greater confidence
  • Consider this therapy for valuable sport horses where minimizing re-injury risk and optimizing tissue healing quality are priorities, though treatment cost and availability may be limiting factors

Key Findings

  • 100% of tpMSC-treated horses vs. 54.5% of placebo achieved improvement in fibre alignment score by Day 112 (p<0.001)
  • Lesion size decreased significantly more in tpMSC group (-27.6±25.91 mm²) compared to placebo (-4.6±26.64 mm², p<0.001)
  • 65% of tpMSC-treated horses achieved complete fibre alignment (FAS=0) versus only 9% in placebo group at Day 112
  • 41 of 53 tpMSC-treated horses showed no re-injury at 2-year follow-up compared to 2 of 26 saline-treated horses (p<0.001)

Conditions Studied

superficial digital flexor tendon (sdft) injuriessuspensory ligament (sl) injuries

Related References

Safety assessment of equine allogeneic tenogenic primed mesenchymal stem cells in horses with naturally occurring tendon and ligament injuries.

Carlier Stephanie, Depuydt Eva, Van Hecke Lore, Martens Ann, Saunders Jimmy, Spaas Jan H(2024)Frontiers in veterinary science

The Evaluation of Equine Allogeneic Tenogenic Primed Mesenchymal Stem Cells in a Surgically Induced Superficial Digital Flexor Tendon Lesion Model.

Depuydt Eva, Broeckx Sarah Y, Van Hecke Lore, Chiers Koen, Van Brantegem Leen, van Schie Hans, Beerts Charlotte, Spaas Jan H, Pille Frederik, Martens Ann(2021)Frontiers in veterinary science

Implantation of bone marrow-derived mesenchymal stem cells demonstrates improved outcome in horses with overstrain injury of the superficial digital flexor tendon.

Godwin E E, Young N J, Dudhia J, Beamish I C, Smith R K W(2012)Equine veterinary journal

Cellular and Humoral Immunogenicity Investigation of Single and Repeated Allogeneic Tenogenic Primed Mesenchymal Stem Cell Treatments in Horses Suffering From Tendon Injuries.

Depuydt Eva, Broeckx Sarah Y, Chiers Koen, Patruno Marco, Da Dalt Laura, Duchateau Luc, Saunders Jimmy, Pille Frederik, Martens Ann, Van Hecke Lore, Spaas Jan H(2021)Frontiers in veterinary science

Tenogenically Induced Allogeneic Mesenchymal Stem Cells for the Treatment of Proximal Suspensory Ligament Desmitis in a Horse.

Vandenberghe Aur&#xe9;lie, Broeckx Sarah Y, Beerts Charlotte, Seys Bert, Zimmerman Marieke, Verweire Ineke, Suls Marc, Spaas Jan H(2015)Frontiers in veterinary science