Authors: Salcedo-Jiménez Ramés, Koenig Judith B, Lee Olivia J, Gibson Thomas W G, Madan Pavneesh, Koch Thomas G
Journal: Frontiers in veterinary science
Summary
Extracorporeal shock wave therapy (ESWT) and mesenchymal stromal cell (MSC) therapy are increasingly used together clinically for equine tendon and ligament injuries, yet the biological rationale for combining them remains unproven. Salcedo-Jiménez Ramés and colleagues investigated whether ESWT enhances the therapeutic properties of equine umbilical cord blood-derived MSCs in vitro, treating three independent cell cultures with an electrohydraulic shock wave generator and assessing proliferation, viability, migration, differentiation capacity, and immunomodulatory function. ESWT-treated cells demonstrated significantly increased metabolic activity and enhanced differentiation toward adipogenic and osteogenic lineages, with successful chondrogenic differentiation across both treated and control groups; however, immunosuppressive properties remained unchanged between treatment groups. These findings suggest that shock wave stimulation may prime MSCs for enhanced bone and fat cell development—potentially beneficial for callus formation in fracture healing—but does not augment the cells' anti-inflammatory signalling capacity. Whilst the in vitro data supports a biological basis for combining ESWT with MSC therapy in equine orthopaedic practice, in vivo validation is essential to establish whether these enhanced metabolic and differentiation responses translate to clinically meaningful improvements in tissue regeneration and functional recovery.
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Practical Takeaways
- •While ESWT combined with MSC therapy is used clinically for tendon and ligament injuries, this in vitro study provides only preliminary cellular support—in vivo evidence is still needed before claiming synergistic benefits
- •ESWT appears to enhance MSC metabolic activity and certain differentiation pathways in the laboratory, but translation to clinical tissue repair remains unproven
- •The similar immunomodulatory effects between treated and untreated cells suggest ESWT does not compromise the immune-regulating benefits of MSC therapy
Key Findings
- •ESWT-treated equine cord blood MSCs demonstrated increased metabolic activity compared to control cells
- •ESWT treatment enhanced adipogenic and osteogenic differentiation potential in CB-MSCs
- •ESWT-treated cells maintained similar immunomodulatory properties to untreated controls
- •Equine CB-MSCs showed positive trilineage differentiation (adipogenic, osteogenic, chondrogenic) when treated with ESWT